人工促勃起状态下对后尿道血管瘤诊治的临床观察  

Diagnosis and treatment of posterior urethral hemangioma in artificial erection state

作　　者：赵虎[1] 张立进 吴斌[1] 姜彬[1] 雒强 杨伟[1] 黄青[1] ZHAO Hu;ZHANG Li-jin;WU Bin;JIANG Bin;LUO Qiang;YANG Wei;HUANG Qing(Department of Urology,Affiliated Jiangyin Hospital of Medical College of Southeast University,Jiangyin 214400,China)

机构地区：[1]东南大学医学院附属江阴医院泌尿外科,江苏江阴214400

出　　处：《现代泌尿外科杂志》2020年第8期712-715,共4页Journal of Modern Urology

摘　　要：目的初步探讨人工促勃起状态下,经尿道内窥镜在后尿道血管瘤的诊治过程中的实用性及安全性。方法回顾性分析东南大学医学院附属江阴医院泌尿外科2015年1月至2018年9月收治的6例后尿道血管瘤患者的诊治过程。所有患者均以勃起或者性生活过程中无痛性肉眼血尿为第一主诉。患者术前均行泌尿系MRI或者CT扫描等检查,以排除泌尿系肿瘤或者结核。患者全身麻醉后以罂粟碱局部注射阴茎海绵体后制造人工促勃起状态,通过内窥镜对所有患者的后尿道进行手术诊治。术后对所有患者进行密切随访,以观察患者的远期疗效及手术并发症。结果全身麻醉后人工促勃起状态下,所有患者在内窥镜下均证实为后尿道血管瘤,患者行经尿道血管瘤电切术,术后留置尿管1周。患者术后2个月开始行性生活。平均随访12.7(10~18)个月,随访过程中未见血管瘤复发及尿道狭窄等远期并发症。结论后尿道血管瘤是一种较为少见的临床疾病,常规检查方法对其诊治具有一定的局限性,人工促勃起状态下通过内窥镜操作可有效提高其临床诊治效果。Objective To explore the practicality and safety of transurethral urethral endoscopy in the diagnosis and treatment of posterior urethral hemangioma in artificial erection state.Methods A retrospective analysis of 6 patients with posterior urethral hemangioma treated in our department during Jan.2015 and Sep.2018 was conducted.The first compliant of all patients was painless gross hematuria during erection or sexual intercourse.All patients underwent urinary MRI or CT scan before surgery to exclude urinary tumors or tuberculosis.After general anesthesia,a topical erectile state was established by local injection of papaverine,and the posterior urethra was observed and surgically treated with endoscopy.All patients were closely followed up to observe the complications and long-term efficacy.Results In the state of artificial erection after general anesthesia,all cases were confirmed as posterior urethral hemangioma.Transurethral resection of the hemangioma was conducted,and urinary catheter was indwelt for one week after operation.The patients started having sexual intercourse 2 months after operation.During the follow-up of 12.7(10-18)months,no long-term complications such as hemangioma recurrence or urethral stricture were observed.Conclusion Posterior urethral hemangioma is a relatively rare disease which is hard to diagnose and treat with conventional methods.Endoscopic operation in artificial erection state can effectively improve the clinical outcomes.

关 键 词：后尿道血管瘤 人工勃起 尿道内窥镜 

分 类 号：R737.15[医药卫生—肿瘤]