腔内手术治疗后尿道狭窄与闭锁(附46例报告)

目的 探讨腔内手术治疗后尿道狭窄与闭锁,提高后尿道狭窄腔内手术成功率.方法 后尿道狭窄患者46例,狭窄段长度0.8～2.5 cm,平均1.5 cm.均行尿道内切开及尿道瘢痕电切术治疗.结果 43例手术成功,手术成功率93.5%（43/46）,其中38例一次成功,5例因狭窄复发而行2、3次腔内手术成功;3例失败原因均为术中尿道出血多视野不清晰而改为开放手术治疗.患者术后均定期行尿道扩张.32例随访6～36个月,排尿通畅.结论 腔内手术治疗后尿道狭窄及闭锁,方法简单,安全有效,是治疗后尿道狭窄的首选方法.术后尿道扩张是预防再狭窄的重要手段.

Endourethral surgery for posterior urethral stricture or atresia (report of 46 cases)

Objective] We approach endourethral surgery for posterior urethral stricture or atresia, improving the success rate of posterior urethral stricture. Methods] This study included 46 cases of old posterior urethral stricture or atresia. The length of stricture segment was 0.8 to 2.5 cm with a mean of 1.5 cm. All cases were operated with endoscopic interal urethrotomy and transurethral scar electrosectomy. Results] The 43 patients have obtained good results. The success rate was 93.5%(43/46) in this series. Among them, 38 cases had normal micturition, and the other 5 cases were underwent endocopic surgery for twice or three times with success because the posterior urethral stricture recurred. The 3 failures were treated by open urethroplasty for the excessive bleeding during the internal urethrotomy. All patients were carried out with urethra dilatation after operation. 32 cases have been followed up for 6 to 36 months, and satisfactory voiding has been achieved in all. Conclusion] Endoscopic surgery is a safe and effective treatment in the treatment of posterior urethral stricture. It should be considered as the first choice to treat the posterior urethral stricture or atresia. Urethral dialatation is necessary to prevent the urethral stricture recurrance.