后尿道狭窄内镜下处理的临床体会  

Clinical experience of posterior urethral stricture under endoscope

作　　者：涂传全[1] 薛鹏[1] 王鲲鹏[1] 王祥波[1] 温峰[1] 

机构地区：[1]徐州医学院附属连云港市第一人民医院泌尿外科,江苏连云港222002

出　　处：《临床泌尿外科杂志》2014年第11期1012-1014,共3页Journal of Clinical Urology

摘　　要：目的：探讨输尿管镜下钬激光内切开治疗后尿道狭窄的疗效和手术技巧。方法：回顾性分析11例患者的临床资料,均采用经尿道联合经膀胱造瘘口输尿管镜下钬激光内切开治疗复杂后尿道狭窄或闭锁。结果：11例患者均一次性手术成功。术中尿外渗1例,表现为阴囊水肿,术中予阴囊穿刺,保持引流管通畅,术后3d水肿消退。术后轻度尿失禁1例,经加强盆底肌锻炼1周后好转。术后随访3个月~6年,均排尿通畅。结论：输尿管镜下钬激光内切开治疗后尿道狭窄或闭锁创伤小,安全有效。术中采用经膀胱造瘘口行后尿道镜检可更加明确后尿道近端走行和狭窄情况,可减少假道并发症并提高疗效。对瘢痕较多者联合电切可提高术中效率和远期疗效。Objective：To investigate the surgical treatment and operation skills of ureteroscopic resection using holmium laser for patients with posterior urethral stricture.Method：The data of 11 cases were retrospectively analyzed,which underwent transurethral resection by holmium laser under ureteroscope.Result：Operations were successful in all the 11 cases.One case of urinary extravasation was found after the procedure,which presented scrotum edema.The patient received scrotal puncture surgery for keeping the drainage unobstructed during the surgery.Scrotum edema completely resolved on the third day after the treatment.One case of mild urinary incontinence was found after the treatment,which improved by pelvic floor muscle training for one week.All the patients were found normal micturition during the follow-up period from three months to six years.Conclusion：Treatment of transurethral resection by holmium laser under ureteroscope is safe and effective.The track and stenosis of proximal urethra could be better detected by ureteroscope through bladder stoma,which could decrease the occurrence of false passage and increase the curative effect.For those patients who have scar,holmium laser combined with transurethral electric resection could improve the operation efficiency and long-term outcome.

关 键 词：输尿管镜 钬激光 经尿道电切 尿道狭窄 

分 类 号：R695[医药卫生—泌尿科学]