包皮环切术致尿道损伤的原因分析及修补方法  

Analysis of the causes and repairment of urethral injury caused by circumcision

作　　者：王锋锋 李虎 苏孟媛 苏嘉明 何祖强 钟自强 Fengfeng Wang;Hu Li;Mengyuan Su;Jiaming Su;Zuqiang He;Ziqiang Zhong(Urology and Andrology Center,Baiyun District Maternal and Child Health Hospital,Guangzhou 510410,China)

机构地区：[1]白云区妇幼保健院泌尿男科中心,广州510410

出　　处：《中华腔镜泌尿外科杂志（电子版）》2023年第4期394-396,共3页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的分析包皮环切术后出现尿道损伤的原因及应对策略。方法回顾性分析广州市白云区妇幼保健院泌尿男科中心2021年1月至2022年6月接诊的4例包皮环切术后尿道损伤患者的临床资料,学习相关文献并予以讨论。结果患者4例(年龄9~12岁),均在外院因"包皮过长,包茎"行器械辅助包皮环切术,其中3例为缝合器类术式,1例为套扎类术式,手术后出现尿道损伤导致尿瘘,4例均在我院接受显微镜下尿道瘘口修补术,术后保留导尿管2~3周,拔管后均痊愈。结论包皮环切手术出现尿道损伤原因主要是临床医师缺乏经验,操作失误引起。必须强调普及包皮手术规范化培训的重要性,泌尿外科医师操作标准、规范对避免包皮环切严重并发症的发生至关重要。Objective To analyse the causes of urtheral injury and repairment after circumcision.Methods The data of 4 cases of urtheral injury after circumcision admitted to Baiyun District Maternal and Child Health Hospital were retrospectively analyzed,then the relevant literature were reviewed and discussed.Results The age of the 4 patients was ranging from 9 to 12 years.All patients in the treatment of phimosis or redundant prepuce received circumcision in other hospitals.One patient underwent the operation with disposable circumcision suture device,and the others underwent the operations with disposable circumcision ligator.All patients had urethral injury and fistula after circumcision.The 4 patients received microsurgical operations to repair urethral fistula in our hospital,and retained the catheter for 2-3 weeks after operations.Finally,they recovered completely after 3 months.Conclusions Urethral injury and fistula after circumcision is mainly caused by lack of experiences and misoperation.Circumcision standardization training should be emphasized.Standard surgical procedures of urologists are important to avoid complications.

关 键 词：包皮环切术 尿道损伤 尿瘘 显微镜手术 医源性损伤 

分 类 号：R699.4[医药卫生—泌尿科学]