经尿道手术治疗尿道闭锁(10年经验总结)  

Endourethral surgery for urethratresia:ten-year clinical experience

作　　者：徐明振 陈书练 张能 崔伟 罗旭 Xu Mingzhen;Chen Shulian;Zhang Neng;Cui Wei;Luo Xu(Department of Urology,the Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou 563099,China)

机构地区：[1]遵义医科大学附属医院泌尿外科,贵州遵义563099

出　　处：《遵义医科大学学报》2020年第5期652-655,共4页Journal of Zunyi Medical University

摘　　要：目的探讨经尿道手术治疗男性尿道闭锁的安全性和疗效。方法回顾性分析我院近10年采用经尿道手术治疗男性尿道闭锁的31名患者资料,通过Kaplan-Meier方法分析第1、2、3次经尿道手术后无狭窄率。结果31名患者中,3例手术失败中转开放尿道成形手术,2例失访,共纳入26例,平均手术时间89 min,平均术中出血量37 mL,术后平均留置导尿管时间1.9个月,平均术后尿道扩张次数14次。经尿道手术治疗男性尿道闭锁术后总体无狭窄率为77%,第1次术后无狭窄率为79%,平均复发时间7个月。第2次术后无狭窄发生率为67%,平均复发时间5个月。短期并发症包括术后出血、感染等,长期并发症包括狭窄复发及勃起功能障碍(ED)。结论经尿道手术治疗男性尿道闭锁安全、有效,配合术后尿道扩张,远期疗效较好。Objective To investigate the safety and effects of endourethral surgery on urethratresia.Methods A total of 31 patients suffered from urethratresia and treated by endourethral surgery in the past 10 years in the affiliated hospital of Zunyi Medical University was retrospectively analyzed.The Kaplan-Meier method was used to analyze stricture-free probability after the first,second and third endourethral surgery.Results Among the 31 patients,three patients were converted to open urethroplasty after operation failure and 2 patients were lost to follow-up.A total of 26 patients were included with an average operation time of 89 min,the average intraoperative blood loss of 37 ml,the average postoperative indwelling catheter time of 1.9 months,and average 14 times of dilatation.The overall non-stricture rate after endourethral surgery for male urethratresia was 77%,and the non-stricture rate after the first operation was 79%with the average recurrence time of 7 months.The second operation stricture-free rate was 67%with the average time to recurrence of 5 months.Short-term complications included postoperative bleeding and infection,while long-term complications included recurrent stenosis and erectile dysfunction(ED).Conclusion Endourethral surgery for male urethratresia is safe and effective.Combined with postoperative urethral dilatation,the long-term effect is satisfactory.

关 键 词：尿道闭锁 内窥镜术 尿道扩张 

分 类 号：R699.6[医药卫生—泌尿科学]