复杂性尿道狭窄和尿道闭锁的腔内治疗体会  

Endourethral Surgery for 46 Cases of the Complicated Urethrostenosis and Urethratresia

作　　者：杨宝龙[1] 鹿尔驯[1] 关维民[1] 李贵军[1] 辛建军[1] 薛娟[1] 

机构地区：[1]解放军海军总医院泌尿外科,北京100037

出　　处：《中华男科学杂志》2006年第2期151-153,共3页National Journal of Andrology

摘　　要：目的：探讨复杂性尿道狭窄和尿道闭锁经尿道腔内治疗效果。方法：回顾性总结46例采用冷刀、等离子体双极电切术或激光技术行窥视下经尿道内切开、切除尿道瘢痕组织治疗复杂性尿道狭窄或尿道闭锁的经验。结果：46例1次手术成功率80．43％（37／46）；需2～3次手术者13．04％（6／46）；腔内手术失败率6．52％（3／46）。手术失败原因为尿道狭窄或尿道闭锁段过长、两断端严重移位、骨盆骨折畸形愈合严重压迫尿道和术后感染。39例（84．78％）获得随访6～84个月，均排尿通畅。结论：内窥镜下经尿道手术是治疗复杂性尿道狭窄和尿道闭锁的有效方法，具有操作简便、创伤小、安全等优点。术前了解尿道狭窄和尿道闭锁段长度、数目、有无假道；术中充分切开并彻底切除瘢痕组织；术后预防感染、正确保留导尿管、定期尿道扩张是保证手术成功的关键。Objective ： To evaluate the endourethral surgery for the complicated urethrostenosis and urethratresia. Methods ： The endourethral surgery, such as internal urethrotomy transurethral scar electrosectomy or transurethral scar plasmakinetic bipolar electrocautery（PKR） or transurethral laser cicatrectomy, were carried out in 46 cases suffering from the complicated urethrostenosis and urethratresia. Results： The curative rate in this series being achieved by once and twice or three times＇operation were 80.43% （39/46）and 13.04% （6/46） respectively. Three cases of treatment failure were caused by long-segment stricture and urethratresia or severe malposition of the urethral proximal and distal to a narrow-caliber area or post-operation infection. Thirty-nine cases have been followed up for 6 to 84 months. Satisfactory voiding has been achieved in all patients. Conclusion ： Endoscopic surgery was believed to be a safe and efficient therapeutic choice for the complicated urethrostenosis and urethratresia. The success of the treatment depends on understanding the lenghth of the stricture before operation, resecting completely the scar tissue with electric or PKR or laser technique during the process, preventing infection and managing appropriately the urethral catheterization after operation.

关 键 词：复杂性尿道狭窄 尿道闭锁 内窥镜术 等离子体双极电切术 

分 类 号：R695[医药卫生—泌尿科学]