创伤性尿道狭窄或闭锁的腔内治疗体会

Endourethral surgery for 82 cases of traumatic urethrostenosis and urethratresia

目的 探讨窥视下经尿道腔内手术治疗创伤性尿道狭窄或闭锁的治疗效果。方法 回顾性总结 82例尿道内切开、经尿道瘢痕电切或激光切除术治疗创伤性尿道狭窄或闭锁的经验。结果 本组 82例 ,手术成功率 95 .12 % (78 82 ) ,其中 1次手术 74例、2次手术 2例、3次和 4次手术各 1例。经尿道手术治疗失败率 4 .88% (4 82 )。手术失败原因为尿道狭窄段长和术后感染。 6 4例 (78.0 5 % )随访 10～ 10 2个月 ,均排尿通畅。结论 内窥镜下经尿道腔内手术是治疗创伤性尿道狭窄或闭锁的首选方法 ,具有操作简便 ,创伤小 ,安全、有效等优点。术前准确了解尿道狭窄段长度、数目、有无假道 ;术中充分切开瘢痕组织 ,热刀或激光彻底去除瘢痕 ;术后预防感染。

Objective To evaluate the endourethral surgery for traumatic urethrostenosis and urethratresia.?Methods The endourethral surgery,such as internal urethrotomy transurethral scar electrosectomy and transurethral laser cicatrectomy,were carried out for 82 cases suffering from traumatic urethrostenosis and urethratresia. Some experiences were learned and summed up.?Results The successful rate in this series being achieved with one and twice to four times was 95.12%(78/82)and rate of failure was 4.88% (4/82). Failure of treatment in 4 cases was caused by long segment stricture and post operation infection. Sixty four cases have been followed up for 10 104 months. Satisfactory voiding have been achieved in all.?Conclusion Endourethral surgery was believed to be a safe and efficient treatment of choice for traumatic urethrostenosis and urethratresia. The success of the treatment depends on understanding thoroughly the stenosed segment of urethra before operation,incising thoroughly the stricture with cold knife and resecting completely the scar with electric or laser techniquc during operation,preventing infection and managing appropriately the urethral catheterization after operation.