直径匹配性递增性尿道内切开术治疗前列腺术后复杂性前尿道狭窄临床疗效  

Diameter-matched and increasing internal urethrotomy treating complicated anterior urethral stricture after benign prostate hyperplasia surgery:report of 39 cases

作　　者：张家华[1] 谢小燕[1] 周占松[1] 吴小军[1] 宋彩萍[1] 周远秀[1] 季惠翔[1] 

机构地区：[1]第三军医大学西南医院全军泌尿外科研究所,重庆400038

出　　处：《第三军医大学学报》2009年第23期2367-2369,共3页Journal of Third Military Medical University

摘　　要：目的研究治疗良性前列腺增生术后复杂性前尿道狭窄的新手术——直径匹配性递增性尿道内切开术的疗效和安全性。方法自2004年1月至2007年7月,对确诊的39例患者(前尿道均不能通过12F尿道探条)行直径匹配性递增性尿道内切开术,用小号尿道内切开镜切开最狭窄段尿道,中号尿道内切开镜切开次狭窄段和次正常段尿道,术后配合尿道扩张和相应药物治疗以抑制瘢痕生成。结果39例患者术后随访4～30个月,最终35例治愈(89.7%),可通过20～24F尿道探子,排泄性膀胱尿道造影显示尿道恢复通畅,最大尿流率(maximum flow rate,Qmaxx)为15.5～39.8ml/s,平均(23.4±6.7)ml/s;3例好转,能通过16～18F尿道探子,Qmax分别为11.2、11.9和14.8ml/s;1例失败,先后经历3次手术,仍不能自行排尿。结论直径匹配性递增性尿道内切开术是治疗良性前列腺增生术后复杂性前尿道狭窄的一种较好的方法。Objective To summary and evaluate a new operation approach, diameter-matched and increasing internal urethrotomy, in the treatment of the complicated anterior urethral stricture after benign prostate hyperplasia surgery. Methods From January 2004 to July 2007, 39 patients with diagnosed complicated anterior urethral stricture （urethral circumference under 12F） after benign prostate hyperplasia surgery underwent diameter-matched internal urethrotomy in our department. First, the worst stricture segment of urethra was incised by a little resectoscope, and the moderate stricture segments and 2 lateral subnormal segments of urethtea were incised by a middle resectoscope for urethrotomy. Urethral sounding and some medicine were given to prevent the urethral scar formation. Results Among the 39 patients, 35 patients were cured （89.7%） after operation, and 20-24F urethral sounds could pass through their urethra with a mean Qmax of 23.4mL/s. The urethral strictures of 3 patients was improved, and only 16-18F urethral sounds passed through their urethra and the Q were 11.2 ml/s, 11.9 m]/s and 14.8 ml/s repectively. The total effective rate was 97.2%. The left one patient failed to resume voluntary micturition despite 3 operations. Conclusion Diameter-matched internal urethrotomy is a satisfactory method for the treatment of complicated anterior urethral stricture after benign prostate hyperplasia surgery.

关 键 词：良性前列腺增生症 尿道狭窄 手术 

分 类 号：R694.506[医药卫生—泌尿科学] R697.3[医药卫生—外科学]