成人尿道旁腺囊肿的诊断及手术方法的选择

Diagnosis and selection of surgical treatment of paraurethral cyst in adults

目的探讨尿道旁腺囊肿诊断及手术治疗方法的选择。方法回顾性分析2011年12月-2022年7月在厦门大学附属第一医院住院、入院诊断为尿道旁腺囊肿的56例患者的临床资料。结果56例患者中,多数为体检或者洗澡时发现尿道口旁肿物,发现肿物到入院时间为2 d~10年。术中2例诊断为阴道前壁肿物,1例为尿道肿物,术后经病理明确诊断,肿物均为平滑肌瘤。53例诊断为尿道旁腺囊肿,本组患者行尿道旁腺囊肿开窗手术15例,行尿道旁腺囊肿囊壁完整切除38例。囊肿完整切除病例中有6例患者因囊肿较大、位置较深,与尿道关系密切,分离过程中损伤尿道,术后留置尿管10~14 d。全部病例均治愈,无并发症发生。随访2个月~10年未见复发。结论尿道旁腺囊肿根据临床表现及查体不难诊断,较大的囊肿由于反复感染与尿道界限不清,极易损伤尿道,建议对较大、位置较深的尿道旁腺囊肿行开窗手术治疗。

Objective To explore the diagnosis and choice of surgical treatment of paraurethral cyst in adults.Methods The clinical data of 56 patients with paraurethral cyst treated at our hospital during Dec.2011 and Jul.2022 were retrospectively analyzed.Results Of the 56 patients,most of the urethral masses were found during physical examination or bathing,and the time between finding of masses and admission was 2 days to 10 years.Two cases were diagnosed as vaginal wall mass,and one as ureal mass,which were confirmed by postoperative pathology as leiomyoma.Fifty-three cases were diagnosed as paraurethral cysts,15 of whom underwent fenestration and 38 complete resection of the cyst wall.In the 38 cases who underwent complete resection of cyst wall,6 had urethral damage due to large and deep cysts closely connected with the urethra,and catheter was indwelled for 10 to 14 days after surgery.All cases were cured without complications.There was no recurrence during the 2 months to 10 years of follow-up.Conclusion Paraurethral cysts are not difficult to diagnose.Large cysts are likely to damage the urethra due to repeated infection and close connection with urethra.We suggest that the large and deep paraurethral cysts should be removed with fenestration.