经会阴尿道端端吻合术治疗后尿道狭窄112例临床分析  

Clinical analysis of transperineal posterior urethra end-to-end anastomosis therapy of 112 cases

作　　者：哈木拉提·吐送[1] 阿布都热扎克·木塔力甫[1] 王文光[1] 木拉提·热夏提[1] 王玉杰[1] 

机构地区：[1]新疆医科大学第一附属医院泌尿中心,新疆乌鲁木齐830054

出　　处：《国际泌尿系统杂志》2015年第5期693-696,共4页International Journal of Urology and Nephrology

摘　　要：目的 评估经会阴尿道端端吻合术治疗创伤性后尿道狭窄的临床疗效.方法 自2009年1月～ 2013年12月共有112例创伤性后尿道狭窄患者在本院行经会阴尿道端端吻合术,尿道狭窄长度1～ 5cm,其中复杂性后尿道狭窄48例.手术方法采用单纯尿道端端吻合术39例,阴茎海绵体中隔切开＋后尿道端端吻合术73例,获完整随访1年的43例患者比较其术前、术后勃起功能情况.结果 112例均成功吻合,术后排尿通畅103例（92％）,其中暂时性尿失禁6例,无永久性尿失禁;再次尿道狭窄9例,其中4例行定期尿道扩张后保持排尿良好,5例手术失败.获完整随访的43例患者中,术前及术后1年国际勃起功能指数-5（IIE F-5）评分及阴茎勃起角度对性生活的影响无显著性差异.结论 经会阴尿道端端吻合术治疗男性创伤性后尿道狭窄成功率高,经充分游离,小于5cm的后尿道狭窄均能实现无张力吻合,手术本身对患者勃起功能及性生活无显著影响。Objectives To evaluate the clinical effect of transperineal urethra end-to-end anastomosis on traumatic posterior urethral stricture.Methods 112 patients of traumatic posterior urethral stricture were treated by transperineal urethra end-to-end anastomosis from Jan.2009 to Dec.2013 in our hospital.The length of stenosis was from I cm to 5cm,with 48 cases of complex posterior urethral stenosis.Transperineal urethra end-to-end anastomosis was performed：43 patients with simple perineal anastomosis;73 patients with separation of the corporeal bodies.Evaluate the erectile founction of 43 patients pre and post operation who have 1 year complete follow-up.Results All 112 patients fulfilled successful end-to-end anastomosis,103 patients（92%） voided well and 6 cases were suffered with provisionally incontinence,no permanent incontinence after operation.9 patients were suffered from urethral stricture again,and 4 of them voided well after regular dilatation postoperatively,5 cases failed.43 cases get 1 year follow up,the International Index of Ereetile Function-5 （IIEF-5） and penile erectile angle have insignificant affect to sexuality pre and post end-to-end anastomotic urethrolasty.Conclusions Transperineal urethra end-to-end anastomosis has highachievement ratio for the management of traumatic posterior urethral stenosis in male,the segment of stenosis less than 5cm can get no tension anastomose by entirely dissociate,this operation has less affection to patient‘s erectile function and sexual intercourse.

关 键 词：尿道狭窄 会阴 吻合术 外科 

分 类 号：R695.4[医药卫生—泌尿科学]