重复尿道内切开术治疗尿道狭窄的疗效观察

Repeated internal urethrotomy for the treatment of male urethral stricture

目的 探讨尿道内切开术治疗尿道狭窄的可重复性。 方法 收集经尿道内切开术治疗的尿道狭窄及闭锁患者共 2 96例 ,分析重复实施尿道内切开术的价值。 结果 2 96例中手术成功 2 6 1例 (88.2 % ) ,其中 1次手术成功者 2 17例 ;行 2次内切开术者 79例 ,32例成功 ,行 3次内切开术者 4 7例 ,12例成功。 35例 (11.8% )手术失败 ,其中 2 6例改行镍钛记忆合金螺旋支架置入治疗 ,9例行开放手术。病程 >1年者重复尿道内切开术成功率低。 结论 尿道内切开术治疗尿道狭窄应争取首次成功 ,重复手术价值有限 ,病程 >1年者不宜行重复尿道内切开术。

Objective To evaluate the efficacy of repeated internal urethrotomy as the treatment for male urethral stricture. Methods A total of 296 patients with proved urethral stricture was treated with optical internal urethrotomy and the value of repeated internal urethrotomy has been analysed. Results Of the 296 patients internal urethrotomy has been successful in 261 (88.2%),217 patients with single operation,twice or three times with successful outcome in 32 and 12 patients respectively.35 patients (11.8%) failed with more than three times internal urethrotomy,of which 26 patients was then treated with stents and 9 required open surgery. Conclusions Internal urethrotomy is an efficacious treatment for male urethral stricture,but repeated operation is of limited value especially when the course of the disease is longer than 1 year.