膀胱镜引导下尿道会师术治疗球部尿道损伤23例临床分析  

Cystoscopy guided treatment of bulbar urethral realignment urethral injury:report of 23 cases

作　　者：郑兵[1] 朱华[1] 潘晓东[1] 顾栋华[1] 陈建刚[1] 陆明[1] 张冰[1] 钱麟[1] 

机构地区：[1]南通大学第二附属医院泌尿外科,南通226001

出　　处：《重庆医科大学学报》2011年第1期117-118,共2页Journal of Chongqing Medical University

摘　　要：目的:探讨球部尿道外伤患者在膀胱镜引导下行腔内尿道会师的手术方法。方法:沿尿道背侧插入尿道镜后通过尿道断裂口,不注水或尽量低压注水,确认进入膀胱后,留置引导管后退镜,再将导尿管套入。结果:23例患者中21例成功,2例改开放手术,直接进镜8例,直视下低压注水进镜13例;并发积液4例,其中3例阴囊、会阴积液,1例阴囊、会阴和盆腔积液。术后3～4周拔管后排尿通畅,6例定期尿道扩张,3例远期尿道狭窄,2例行尿道内切开,1例行狭窄段切除端端吻合术。结论:采用膀胱镜引导下尿道会师术是一种创伤小的手术方法,不注水或尽量低压注水,对大部分球部尿道损伤患者适用。Objective：To search for a safe and convenient surgical method,urethral realignment,for management of bulbous urethral disruption.Methods：Cystoscopy was used to bypass the ruptured segment by introducing a guide-wire through its channel to the bladder without water injection or low pressure water injection,and then a silicone catheter（F18） was sent into bladder passed over the guide wire.Results：Urethral realignment was accomplished successfully in 21 of 23 cases.8 cases underwent no water injection and 13 cases underwent low pressure water injection under direct viewing.Open surgery was necessitated in 2 cases.Effusion developed in 4 cases,3 in scrotum and perineum,1 in scrotum,perineum and pelvic cavity.Urine flowed fluently after catheter was removed at 3～4 weeks after operation.Routine postoperative urethral dilation was performed on 6 patients.Strictures developed in 3 cases,2 of which underwent internalurethrotomy and 1 underwent anastomosis.Conclusion：Urethral realignment with the urethral guidance by cystoscopy without water or with low pressure water injection is a safe,mini-invasive and effective surgical strategy for the management of bulbous urethral disruption.

关 键 词：膀胱镜 尿道会师术 球部尿道外伤 

分 类 号：R699.6[医药卫生—泌尿科学]