排尿期尿道超声显像在男性尿道疾病诊断中的应用  

The clinical application of sonourethrography during micturition for the detecti on of urethral diseases in men

作　　者：刘鸿玉[1] 张化一[1] 庄庆峻 王淑玲[1] 蒋雪梅[1] 王海庆[1] 

机构地区：[1]山东省交通医院介入超声室,济南250031 [2]济南市市中区卫生防疫站

出　　处：《中华泌尿外科杂志》2005年第9期635-638,共4页Chinese Journal of Urology

摘　　要：目的探讨排尿期尿道超声显像在男性尿道疾病诊断中的临床应用价值。方法对58例尿道疾病患者及8例正常尿道行排尿期尿道的经会阴及经阴茎超声检查。其中膀胱颈口尿道梗阻8例,良性前列腺增生(BPH)致尿道梗阻16例,急性尿道炎19例,慢性尿道炎7例、合并狭窄2例,尿道外伤性狭窄2例,尿道瘘2例,假性尿道、尿道炎性息肉、尿道尖锐湿疣和尿道癌各1例。结果排尿期尿道超声显像可动态观察膀胱颈口开放及后尿道顺应性扩张情况,膀胱颈口梗阻及良性前列腺梗阻表现为随着膀胱底及基底部下降,尿道内口被挤压形成颈口狭窄,而其以下水平尿道扩张正常或降低,患者愈用力排尿,梗阻愈加重。对急慢性尿道炎可明确炎症部位、范围、程度、有无脓栓附着等,同时对尿道慢性炎性狭窄或外伤性狭窄以及假性尿道、尿道瘘、尿道赘生物及恶性肿瘤等显像良好。结论排尿期尿道超声检查为非侵入性检查、可重复性强,对尿道疾病的诊断及治疗效果评价具有重要的临床意义。Objective To investigate the clinical application of sonourethrography during micturition for the detection of urethral diseases in men. Methods Sonourethrography via perineum or penis during micturition was performed in 58 male patients with urethral diseases and 8 subjects with normal urethra. Of the 58 patients, 8 had urethral obstruction at bladder neck orifice; 16 had BPH-associated urethral obstruction; 19 had acute urethritis; 7 had chronic urethritis （of them 2 were complicated by stricture）; 2 had traumatic urethral stricture; 2 had urethral fistula; 1 had false passage; 1 had urethral inflammatory polyp; 1 had pointed condyloma of urethra and 1 had carcinoma of urethra. Results Sonourethrography during micturition dynamically displayed the situation of vesical neck outlet opening and the obedience of posterior urethra dilation. In BOO and BPO, with the descent of bladder fundus and basal part, the internal urethra orifice was pressed to form a stricture at the vesical orifice; however, the dilation of part of the urethra below this level was normal or decreased, so that the more exertion the patient made during micturition, the worse the obstruction become. Sonourethrography during micturition could also indicate the site, scope, adhesion of pus and severity of the urethral tract bacterial infections. In addition, it could display good images of urethral stenosis, false passage,urethral fistula, urethral caruncula and carcinoma. Conclusions Sonourethrography during micturition for the detection of urethral condition is a noninvasive examination. It can provide more information compared with retrograde urethrography. This method has great value in diagnosing urethral diseases and evaluating the curative effects.

关 键 词：超声检查 排尿期尿道 尿道疾病 尿道超声显像 男性尿道 疾病诊断 排尿期 良性前列腺增生(BPH) 膀胱颈口梗阻 慢性尿道炎 

分 类 号：R445.1[医药卫生—影像医学与核医学]