Endoscopic Internal Urethrotomy in the Treatment of Male Urethral Stenosis in the Urology-Andrology Department of KARA Teaching Hospital (Togo)

Introduction: Endoscopic internal urethrotomy (EIU) is a method for stricture opening using transurethral incision by direct visualisation of the urethral channel, resulting in a widening of the urinary canal with the aim of improving the quality of bladder emptying. The aim of the study was to evaluate the indication and results of EIU in the treatment of stenosis of the male urethra in the Urology-Andrology Department of Kara Teaching Hospital. Methodology: This was a cross-sectional descriptive study with retrospective data collection in the Urology-Andrology department of Kara Teaching Hospital. It involved 21 records of patients with urethral stenosis treated by endoscopic internal urethrotomy (EIU) in the said department during the period from January 2021 to September 2023. The following variables were evaluated: age, circumstance of discovery, site, length, number, etiology of the urethral stenosis and evolution of the patients. Results: The mean age of the patients was 59.2 ± 11.7 years. Infectious etiology of stenosis was predominant with 10 patients (47.6%) followed by trauma with 5 cases (23.8%). The bulbar urethra was the most frequently observed site, with 11 cases (52.4%). The length was mostly less than 2 cm in 12 patients (57.1%). Stenosis was unique in 14 patients (66.7%). The mean postoperative follow-up time was 3.2 months. The result was immediately better in 11 patients (52.4%) and it was poor in 8 patients (38.1%) who required maintenance dilation sessions.

Management of urethral strictures and stenosis caused by the endo-urological treatment of benign prostatic hyperplasiad-a single-center experience

Objective:Urethral stricture disease after endo-urological treatment of benign prostatic hyperplasia(BPH)is a sparsely described complication.We describe management of five categories of these strictures in this retrospective observational case series.Methods:One hundred and twenty-one patients presenting with symptoms of bladder outflow obstruction after endo-urological intervention for BPH from February 2016 to March 2019 were evaluated.Among them,76 were eligible for this study and underwent reconstructive surgery.Preoperative and postoperative assessments were done with symptom scores,uroflowmetry,ultrasound for post-void residue,and urethrogram.Any intervention during follow-up was classed as a failure.The recurrence and 95%confidence interval for recurrence percentage were calculated.Results:The following five categories of patients were identified:Bulbo-membranous(33[43.4%]),navicular fossa(21[27.6%]),penile/peno-bulbar(8[10.5%]),bladder neck stenosis(6[7.9%]),and multiple locations(8[10.5%]).The average age was 69 years(range:60-84 years).Overall average symptom score,flow rate,and post-void residue changed from 21 to 7,6 mL/s to 19 mL/s,and 210 mL to 20 mL,respectively.The average follow-up was 34 months(range:12-58 months).Overall recurrence and complication rates were 10.5%and 9.2%,respectively.The recurrence in each category was seen in 3,1,2,1,and 1 patient,respectively.Overall 95% confidence interval for recurrence percentage was 4.66-19.69.Conclusion:Urethral stricture disease is a major long-term complication of endo-urological treatment of BPH.The bulbo-membranous strictures need continence preserving approach.Navicular fossa strictures require minimally invasive and cosmetic consideration.Peno-bulbar strictures require judicious use of grafts and flaps.Bladder neck stenosis in this cohort could be treated with endoscopic measures.Multiple locations need treatment based on their sites in single-stage as far as possible.

Penile Skin Flap Urethroplasty for Urethral Stenosis at SominéDOLO Hospital of Mopti (MALI)

Introduction: Penile skin flap urethroplasty is a technique for replacing or enlarging an obstructed urethra. We aim to report our experience in the practice of this surgical technique. Patients and method: This was a prospective and descriptive study of penile skin flap urethroplasty indicated for urethral stenosis between January 2014 and December 2019. Results: A total of 21 penile skin flap urethroplasties for urethral stenosis were performed. The average age was 38.6 years old. The stenosis was of sclero-inflammatory origin in 15 cases (71.43%). It was of bulbo-perineal, penile, and penile-bulbar topography in about a third each. A history of urethral surgery was reported in 80.95% of the cases. The average length of the stenosis was 6.8 cm. Mundy circular skin flap urethroplasty about 15 cases (71.43%), and Quartey rectangular skin penile flap urethroplasty about 6 cases (28.57%) were the surgical techniques performed. The postoperative follow-up was favorable in 19 cases (90.48%). Two cases of urethral fistula (9.52%) underwent the 2nd urethroplasty. Urination at 1 year was satisfactory. No relapse has been reported to date. However, 4 patients (19.04%) reported asthenic ejaculation, and 1 patient (4.76%) a marked decrease in sexual pleasure. Conclusion: This surgical technique is effective in terms of voiding when the surgical indications are well chosen. The sexual aspect must be taken into account and the intervention only offered to those who really need it.

Posterior urethral stenosis:Contemporary management options

Posterior urethral stenosis(PUS)is a known complication following prostate cancer treatment as well as other benign endoscopic treatments.Patients with PUS often fail initial endoscopic treatments and have persistent symp-toms negatively affecting quality of life.In the past decade,a variety of dif-ferent surgical techniques and approaches have changed the landscape of PUS management.The goal of this review is to provide details on the his-torical,current,and future direction of the surgical management for PUS.

Efficacy comparison between Mathieu combined urethral plate incision and onlay island flap urethroplasty for distal hypospadias in patients with urethral plate stenosis

The aim of the study was to compare the efficacy of Mathieu combined urethral plate incision(Mathieu-IP)versus onlay island flap urethroplasty in patients with distal hypospadias complicated by urethral stenosis.The clinical data of 70 patients with distal hypospadias complicated by urethral plate stenosis treated in the Department of Urology,Anhui Provincial Children’s Hospital(Hefei,China),from May 2019 to May 2022,were retrospectively analyzed.Thirty-eight patients underwent Mathieu-IP(Mathieu-IP group)and 32 underwent onlay island flap urethroplasty(Onlay group).Follow-ups at 1 month,6 months,and 12 months postoperatively assessed operative time,complications,urethral meatus morphology,and family satisfaction.The Mathieu-IP group had significantly shorter operative time(mean±standard deviation[s.d.]:81.58±5.18 min)versus the Onlay group(mean±s.d.:110.75±6.05 min;P<0.05).Surgical success rates were 78.9%(Mathieu-IP group)and 75.0%(Onlay group),with no significant difference(P>0.05).Complications were comparable between the groups.The Mathieu-IP group resulted in a vertical slit-shaped urethral meatus in 89.5%versus 13.8%in the Onlay group(P<0.05).Family satisfaction with general penile appearance and skin shape showed no significant differences,but the Mathieu-IP group had higher satisfaction with meatal position(P<0.05).Mathieu-IP offers simplicity,safety,and shorter operative time compared to Onlay.Both the techniques effectively treat urethral plate stenosis in distal hypospadias,with reduced postoperative complications compared to tubularized incised plate urethroplasty.Mathieu-IP results in a vertical slit-shaped urethral meatus which enhances urinary stream,indicating its potential for broader adoption.

Re:Posterior urethral stenosis:Contemporary management options

Surgical management of posterior urethral stenosis(PUS)following treatment for prostate cancer is one of the most challenging aspects of urethral reconstructive surgery,especially in patients who have undergone multimodal therapies such as radiation therapy and surgical prosta-tectomy.In the modem era,treatment of prostate cancer often includes surgical extirpation,radiation-based treatments(external beam or internal application with implanted seeds),or other energy-based treatments like high-frequency focused ultrasound or cryotherapy.

输尿管软镜下钬激光碎石治疗输尿管上段结石并发输尿管狭窄的危险因素分析

目的探讨输尿管软镜下钬激光碎石治疗输尿管上段结石并发输尿管狭窄的危险因素。方法选取输尿管上段结石患者988例,根据手术设备不同分为软镜组和硬镜组,比较两组皮质醇(Cor)、C反应蛋白(CRP)水平。软镜组根据术后有无并发输尿管狭窄分为狭窄组和非狭窄组,采用多因素Logistic回归分析输尿管狭窄的危险因素。结果两组术后Cor、CRP水平均高于术前,且软镜组低于同时间硬镜组(P<0.05)。软镜组输尿管狭窄发生率为5.60%。病程、结石直径、结石嵌顿和输尿管损伤是并发输尿管狭窄的独立危险因素(P<0.05)。结论输尿管软镜对该类患者机体应激反应影响更小,且病程、结石直径、结石嵌顿及输尿管损伤是并发输尿管狭窄的独立危险因素。

小肠黏膜下层脱细胞基质复合外泌体构建组织工程尿道

背景:小肠黏膜下层脱细胞基质已被临床与基础研究证实可用于尿道的修复重建,但其单独应用时存在宿主细胞生长缓慢、支架血管化不足而成活困难、重建尿道狭窄梗阻等问题,仅适用于较短的尿道狭窄。目的:探讨应用小肠黏膜下层脱细胞基质复合外泌体构建组织工程尿道的可行性。方法:从新西兰大白兔骨髓间充质干细胞中分离提取外泌体;制备猪小肠黏膜下层脱细胞基质,将外泌体负载于小肠黏膜下层脱细胞基质上。将小肠黏膜下层脱细胞基质-外泌体(PKH26染料标记)复合物与脐静脉内皮细胞共培养12 h,观察细胞摄取外泌体情况。选取生长状态良好的脐静脉内皮细胞,分3组培养:空白组常规培养,对照组加入小肠黏膜下层脱细胞基质,实验组加入小肠黏膜下层脱细胞基质-外泌体复合物,通过划痕实验、成管实验、血管生成因子分泌检测评估血管生成情况。取30只新西兰大白兔,建立长段(3 cm)尿道缺损模型,采用随机数字表法分3组干预(n=10):单独材料组植入小肠黏膜下层脱细胞基质,对照组植入小肠黏膜下层脱细胞基质-骨髓间充质干细胞复合物,实验组植入小肠黏膜下层脱细胞基质-外泌体复合物,植入后12周进行尿道造影、尿动力学检查及重建尿道切片病理观察。结果与结论:(1)荧光显微镜下可见小肠黏膜下层脱细胞基质中的外泌体可被脐静脉内皮细胞摄取。(2)与空白组、对照组相比,实验组材料可促进脐静脉内皮细胞的迁移、成血管能力以及成血管因子血管内皮生长因子、肝细胞生长因子、白细胞介素8的分泌(P <0.05)。(3)尿道造影结果显示,单独材料组10只兔均出现尿道狭窄,对照组10只兔中2只出现尿道狭窄,实验组10只兔均未出现尿道狭窄。尿动力检查结果显示,单独材料组兔材料植入后12周的最大尿道压高于术前(P <0.05),对照组、实验组兔植入后12周的最大尿道压均低于空白组(P <0.05)。苏木精-伊红、Masson与免疫组化染色显示,单独材料组可见明显的再生上皮层、少量的皮下平滑肌与血管,以纤维组织增生为主,伴有明显炎性细胞浸润;对照组可见较完整的再生上皮与少量胶原,可见大量的皮下血管与平滑肌,伴有炎性细胞浸润;实验组可见完整的再生上皮层与大量的皮下血管、平滑肌,未见明显炎性细胞浸润,实验组AE1/AE3、ɑ-平滑肌肌动蛋白、CD31阳性表达均高于单独材料组、对照组(P <0.05)。(4)结果表明,小肠黏膜下层脱细胞基质-外泌体组织工程尿道可通过促进血管生成来修复尿道缺损。

老年前列腺增生合并糖尿病患者经尿道电切术后尿道狭窄的预测模型构建与验证

目的构建老年前列腺增生(BPH)合并糖尿病(DM)患者经尿道前列腺电切术(TURP)术后尿道狭窄(US)的预测模型,并进行外部验证,旨在为临床防治提供参考依据。方法回顾性选取2021年3月至2022年8月于新乡医学院第一附属医院接受TURP治疗的老年BPH合并DM患者365例作为建模样本,根据术后3个月是否发生US分为狭窄组42例与未狭窄组323例。比较两组患者的临床资料,采用Lasso-Logistic回归分析术后US的独立影响因素,构建列线预测模型,采用校正曲线、受试者工作特征曲线(ROC)和决策曲线分析(DCA)评估预测模型的预测价值。另选取2022年9月至2023年9月于新乡医学院第一附属医院接受TURP治疗的BPH合并DM患者127例作为验证样本,分为狭窄组14例与未狭窄组113例,采用ROC和DCA曲线验证预测模型在验证样本中的预测价值。结果建模样本、验证样本中两组的前列腺体积、DM病程、国际前列腺症状(IPSS)评分、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、术前合并尿路感染、既往导尿史、手术时间、术中出血量、术后导尿管留置时间、术后导尿管牵引时间比较,差异均有统计学意义(P<0.05);经Lasso-Logistic回归分析结果显示,前列腺体积、DM病程、IPSS评分、FBG、HbA1c、术前合并尿路感染、手术时间、术后导尿管留置时间均是老年BPH合并DM患者TURP术后US的独立危险因素(P<0.05);构建列线预测模型,校正曲线显示,该模型一致性指数(C-index)为0.879,校准度为0.902,ROC显示,该模型预测建模样本术后US的AUC为0.855(95%CI:0.782~0.928),预测验证样本术后US的AUC为0.935(95%CI:0.852~1.000),DCA曲线显示,该模型净获益优于两种极端情况,具有较高临床正向净获益。结论前列腺体积、DM病程、IPSS评分、FBG、HbA1c、术前合并尿路感染、手术时间、术后导尿管留置时间是老年BPH合并DM患者TURP术后发生US的独立危险因素,基于上述因素构建列线预测模型具有较高预测效能及临床适用性,可为临床预测TURP术后US的发生风险提供可靠预测方式。

尿道狭窄合并尿道结石患者应用经输尿管镜钬激光术的疗效分析

目的探讨尿道狭窄合并尿道结石患者进行经输尿管镜钬激光术的临床疗效。方法选取2021年10月—2023年10月于武威市中医医院外科就诊的尿道狭窄合并尿道结石患者68例,采用随机数字表法分为观察组与对照组,各34例。对照组患者采用常规的电切镜冷刀术治疗,观察组采取经输尿管镜钬激光术治疗。比较2组患者的临床疗效、手术情况及并发症发生情况。结果观察组总有效率(88.23%))高于对照组(52.94%),差异有统计学意义(P<0.05)。观察组的术中出血量、膀胱痉挛次数、碎石时间及手术时间均低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率(8.82%)低于对照组(29.41%),差异有统计学意义(P<0.05)。结论对尿道狭窄合并尿道结石患者进行治疗时,可以采取经输尿管镜钬激光术,不仅可以有效提高患者的临床疗效,而且也能够确保手术的顺利进行,使患者的手术指标更加稳定,促进患者早日康复。

外伤致尿道狭窄患者经会阴入路尿道重建术后复发的危险因素分析及其预测模型的构建

目的:探讨外伤致尿道狭窄患者经会阴入路尿道重建术后复发的危险因素分析及其预测模型的构建。方法:将2018年1月至2020年12月在濮阳市中医医院接受治疗的外伤所致尿道狭窄的患者211例的数据实施回顾性分析。外伤致尿道狭窄患者经会阴入路尿道重建术后复发的单因素、多因素分析。外伤致尿道狭窄患者经会阴入路尿道重建术后复发的预测模型构建和预测效能分析。结果:纳入研究的患者之中,共有36例复发,复发率为17.06%。单因素分析结果显示,术后复发情况不同的患者的罹患糖尿病情况、吸烟情况、术前行尿道扩张情况、狭窄尿道近端和耻骨相对位置情况以及术前血清总蛋白水平的数据差异有统计学意义(P<0.05)。Logistic多因素分析结果显示,罹患糖尿病情况、吸烟情况、术前行尿道扩张情况、狭窄尿道近端和耻骨相对位置情况以及术前血清总蛋白水平是外伤致尿道狭窄患者经会阴入路尿道重建术后复发的独立影响因素(P<0.05)。依据多因素分析所筛选出来的变量构建列线图风险模型,C-index为0.823。利用Bootstrap自抽样法进行内部验证,重复自抽样1000次,获得校准曲线,平均绝对误差为0.019。利用列线图模型对外伤致尿道狭窄患者经会阴入路尿道重建术后复发情况进行ROC曲线的预测,约登指数为67.00%。结论:外伤致尿道狭窄患者术后具有一定的复发风险,包括吸烟在内的若干因素是患者复发的独立影响因素;而基于各影响因素的预测模型能够较为良好的预测患者复发的结果。

Surgical treatment of pelvic fracture urethral distraction defects in boys:which approach is suitable?

Pelvic fracture urethral distraction defects(PFUDDs)are relatively infrequent in boys,and treatment for PFUDDs presents one of the most difficult problems in urological practice.Anastomotic urethroplasty is considered an ideal surgical procedure for PFUDDs in boys.However,various surgical approaches for anastomotic urethroplasty have been proposed,including a simple transperineal approach,a tran sperineal in tercorporal septal separati on approach,a tran sperineal in ferior pubic approach,and a combined transpubic・perineal approach.This study aims to determine which surgical approach is best for PFUDDs in boys.We retrospectively identified 22 boys with PFUDDs aged 2-14 years who underwent anastomotic urethroplasty via different approaches between January 2008 and December 2017.Follow-up was performed in all the 22 patients for 6-123(mean:52.0)months.Finally,20 of the 22 boys(90.9%)were successfully treated,including 1 of 2 patients treated with a simple transperineal approach,3 of 3 with a transperineal approach with intercorporal septal separation,14 of 15 with a transperineal inferior pubic approach,and 2 of 2 with a combined transpubic-perineal approach.Two patients had failed outcomes after the operation,and stenosis recurred.Based on the outcome of the 22 patients,we can draw a preliminary conclusion that most boys(20/22)can be treated with a transperineal inferior pubic approach or simpler procedures without the need of completely removing or incising the pubis.The combined transpubic-perineal approach can be used in cases of extremely long urethral distract defects.

盆底三维超声对压力性尿失禁的诊断价值及对经闭孔无张力尿道中段悬吊手术后疗效的评估作用

目的:探讨盆底三维超声对压力性尿失禁(SUI)的诊断价值及对经闭孔无张力尿道中段悬吊手术后疗效的评估作用。方法:选取2018年10月—2020年10月佳木斯骨科医院收治的100例接受经闭孔无张力尿道中段悬吊手术的SUI患者作为研究对象,手术前后均给予盆底三维超声检测,比较两组患者术前术后各超声参数。结果:术前存在漏斗率高于术后,差异有统计学意义(χ2=14.286,P<0.05);术前漏斗深度、宽度均高于术后,差异有统计学意义(t=93.917、56.523,P<0.05);术前膀胱尿道连接部的直接移动度(UVJ-M)、静息期膀胱尿道后角、Valsalva膀胱尿道后角、静息期盆膈裂孔面积、Valsalva盆膈裂孔面积、Valsalva吊带中点—尿道中点距离、静息期吊带成角、Valsalva吊带成角高于术后,差异有统计学意义(t=11.660、29.650、14.698、16.040、16.659、17.478,P<0.05)。术前静息期耻骨直肠肌厚度、Valsalva耻骨直肠肌厚度、静息期吊带中点—尿道中点距离低于术后,差异有统计学意义(t=5.590、13.444、11.456,P<0.05)。结论:盆底三维超声在SUI诊断中以及对经闭孔无张力尿道中段悬吊手术后的效果评估中效果显著。

69例尿道下裂术后尿道狭窄的治疗经验分析

目的通过观察尿道下裂术后尿道狭窄的不同治疗方法及效果,探讨最合适的治疗方案。方法对2005—2016年69例尿道下裂手术后出现尿道狭窄患儿的临床资料进行回顾性分析。所有患儿随访6个月至11年,患儿发生尿道狭窄时,首先予以尿道扩张,最终以患儿排尿通畅、尿线粗、无尿道憩室为治愈标准(包括间隔时间>2个月行尿道扩张1次的轻度尿道狭窄患儿)。结果69例尿道下裂术后出现尿道狭窄患儿中,22例经间断规律尿道扩张治愈(31.88%);28例(40.58%)通过间断尿道扩张后缓解时间较短,经留置多孔硅胶软管支架治愈;13例(18.84%)采用尿道扩张及留置支架管后无改善行尿道狭窄切开,同期行尿道成形术,治愈8例,3例出现尿道狭窄,经尿道扩张治愈,2例出现尿道瘘,6个月后尿道瘘修补成功治愈;6例(8.7%)尿道探针无法通过,尿道扩张未成功,采用切除尿道瘢痕,一期预置尿道板,二期行尿道成形术,治愈4例,1例尿道瘘6个月后行尿道瘘修补术成功治愈,1例出现尿道狭窄,经尿道扩张治愈。结论对于尿道下裂术后尿道狭窄的患儿,根据个体狭窄情况选择普通尿道扩张,或短时留置硅胶软管支架,可有效解决狭窄问题,临床效果肯定,有推广价值;尿道扩张失败的患儿应行尿道狭窄切除术,并同期或分期行尿道成形术。

尿道狭窄的腔内治疗

目的探讨腔内技术治疗尿道狭窄或闭锁,提高手术的成功率。方法该组32例尿道狭窄,其中前尿道狭窄7例,球部尿道狭窄4例,膜部尿道狭窄9例,前列腺部尿道狭窄12例,采用窥视下冷刀和电刀等治疗。结果10例1次手术即获得成功,14例术后行尿道扩张术,7例再次行腔内手术后,随访5～25个月,有效率达97.0%。结论作者认为腔内手术治疗尿道狭窄创伤小、并发症少,成功率较高,效果良好。

经腹腔镜先天性肥厚性幽门狭窄手术

目的探讨小儿先天性肥厚性幽门狭窄腹腔镜微创手术操作要点及经验教训。方法回顾性分析本组20例患儿全麻下经腹腔镜行幽门环肌切开术。结果18例一次手术成功,1例术中中转开腹,1例3d后二次手术。全部病例随访2月,预后较好。结论腹腔镜手术治疗先天性肥厚性幽门狭窄是腔镜技术在新生儿外科领域的成功运用,掌握操作要点,可推广使用。

直视下冷刀尿道内切开术或尿道内电切术治疗尿道狭窄和闭锁

该文介绍了在直视下用冷刀尿道内切开术或尿道内电切术切除疲痕组织治疗３７例尿道狭窄和闭锁。随访１～８年，效果满意。认为用电切术彻底切除尿道瘢痕组织比单纯用冷刀切开瘢痕组织效果要好。该术式具有操作简单、并发症少、痛苦少、恢复快等优点。应作为尿道狭窄和闭锁的首选治疗方法。

钛镍合金螺旋记忆支架置入术治疗尿道狭窄

目的探讨钛镍合金螺旋记忆支架置入术治疗儿童尿道狭窄的临床疗效。方法采用麻醉下尿道扩张和(或)尿道镜切开尿道狭窄环或闭锁段后置入钛镍支架治疗尿道狭窄患儿。结果共治疗尿道狭窄35例,其中尿道下裂术后前尿道狭窄22例,成功18例,带管观察3例,1例好转;外伤性后尿道狭窄9例,成功2例,带管观察6例,1例无效;医源性尿道狭窄4例,后尿道狭窄1例成功,前尿道狭窄2例成功,1例带管观察。结论钛镍合金螺旋记忆支架置入术治疗尿道狭窄是一种创伤小、疗效好的方法。

重度二尖瓣狭窄伴小左室的外科治疗

【目的】探讨重度二尖瓣狭窄伴小左室病人外科治疗的围术期特点。【方法】对本院 1990年 1月至 2 0 0 3年 4月 2 14例风湿性心脏病二尖瓣病变行二尖瓣替换术 (MVR)的病人中重度二尖瓣狭窄伴小左室36例进行回顾性分析。【结果】术后死亡 5例 ( 13.9% ) ,明显高于同期二尖瓣狭窄非小左室病人 ;3例为术后严重低心排导致多脏器功能衰竭 ,1例为大出血 ,1例为急性肾功能衰竭。术后低心输出量综合征发生率为2 7.8%。【结论】重度二尖瓣狭窄伴小左室虽然是手术的高危指标 ,但不是手术禁忌 ,术中选用较小型号的瓣膜并注意心肌保护 。

钬激光联合肾筋膜扩张器治疗男性尿道狭窄体会

目的：探讨联合应用钬激光、肾筋膜扩张器治疗尿道狭窄的临床操作方法及应用价值。方法：应用肾筋膜扩张器对33例尿道狭窄患者行尿道狭窄扩张术,27例尿道未闭锁者直接留置斑马导丝,6例尿道闭锁者应用输尿管镜配合钬激光打通尿道后留置斑马导丝,应用F8~F22肾筋膜扩张器依次扩张狭窄尿道。15例有较多瘢痕组织或狭窄段较长者应用钬激光修整。结果：33例病例1个月后拔除尿管排尿症状较前明显改善,术后定时尿道扩张后排尿舒畅,无并发症。结论：钬激光联合肾筋膜扩张器治疗男性尿道狭窄安全性高,创伤小,疗效好,值得推广采用。