长段外伤性球尿道狭窄行尿道内切开术的有效性和注意事项  

The effectiveness and precautions of internal urethrotomy for long-length traumatic bulbar urethral strictures

作　　者：谭靖[1] 曾青[1] 蒋先镇[1] 何乐业[1] 汤育新[1] 蒋志强[1] 汪金荣[1] 

机构地区：[1]中南大学湘雅三医院泌尿外科,湖南长沙410013

出　　处：《中国内镜杂志》2013年第9期897-901,共5页China Journal of Endoscopy

摘　　要：目的回顾性分析5年中应用球尿道狭窄段内切开术和球尿道狭窄段切除尿道重建术治疗狭窄段〉1cm的外伤性球尿道狭窄病例，评估应用尿道内切开术处理长段球尿道狭窄的有效性。方法收治的86例外伤性球尿道狭窄患者，狭窄段长1～3cm。28例行球尿道狭窄段切除尿道重建术，4例术后行持续尿道扩张；58例行球尿道狭窄内切开术，33例术后行持续尿道扩张。所有患者术后通过尿流率检测、尿道狭窄复发等评估手术效果。结果28例患者行球尿道狭窄段切除尿道重建术，1例尿道狭窄复发；58例患者行球尿道狭窄内切开术，16例尿道狭窄复发。术后坚持持续尿道扩张能明显降低尿道内切开术术后尿道狭窄复发的风险。结论尿道内切开术结合术后持续尿道扩张能成为治疗长段外伤性球尿道狭窄的有效手术方式之一。[ Objective ] To evaluate the effectiveness of internal urethrotomy dealing with long-length bulbar urethral strictures, we have retrospectively analyzed the application of internal urethrotomy and urethroplasty surgery treating long-length （〉1 cm） traumatic bulbar urethral strictures and presented our 5-years experience. [ Methods ] A total of 86 males with traumatic bulbar urethral stricture treated in our urologic department were included ,the length of strictures between 1 cm and 3 cm. Out of 86 included patients 28 were treated with bulbar urethreplasty surgery and 4 patients received postoperative intermittent urethral dilatations; 58 were treated with Holmium laser internal urethrotomy and 33 received postoperative intermittent urethral dilatations. All cases were evaluated by postoperative uroflowmetry and recurrence of urethral strictures. [ Results ] Out of the 86 patients analyzed, 28 had performed bulbar urethroplasty and 1 in this group had postoperative urethral stricture; 58 had performed Holmium laser internal urethrotomy and 16 in this group had postoperative urethral stricture. The group of internal urethrotorny had a higher grade recurrence rate of urethral strictures compared with urethroplasty. Postoperative urethral dilata- tions significantly reduced the stricture recurrence. [ Conclusions ] Internal urethrotomy with postoperative intermit- tent urethral dilatation is one of preferred therapeutic method dealing with long-length bulbar urethral strictures.

关 键 词：尿道内切开术 尿道狭窄 尿道扩张 

分 类 号：R696[医药卫生—泌尿科学]