尿道狭窄或闭锁的腔内手术治疗(附42例报告)

Endourethral surgery for urethral stricture and urethral atresia (Report of 42 cases)

目的 提高尿道狭窄及闭锁的腔内手术治疗效果。方法 总结42例尿道狭窄及闭锁经腔内手术治疗的经验。结果 39例(92.8％)手术成功,其中1次性手术36例,2次手术2例,3次手术1例。失败3例(3.2％),手术失败者与闭锁段较长有关,其中2例改行尿道套入式吻合,1例损伤尿道外括约肌,带膀胱造瘘管出院。结论证明该术式创伤少,可重复操作,疗效确切,认为腔内手术可作为治疗尿道狭窄或闭锁的首选方法。

Objective To evaluate the endourethral surgery for urethral stricture and urethral atresia. Methods 42 patients suffering from urethral stricture or urethral atresia were treated with endourethral surgery, and the follow-up study were carried out. Results The success rate in this series was 92. 8% (39/42). 36 patients were cured with primary surgical operation, 2 cases needed a repeated operation, and for 1 case operation was carried out for 3 times. The cases of 3 failures were due to long-segment stricture, and among them, 2 cases converted to pull-though operation. 1 case had to detain a cystostomy tube until discharged from hospital because of sphincter urethrae muscle in jury. Conclusion Endourethral surgery has advantages of less injury, repeated manipulation possibility, reliable curative effect, and so on. It should be considered as the procedure of first choice for the treatment of urethral stricture and urethral atresia.