前尿道损伤早期处理的治疗体会

目的 探讨前尿道损伤早期处理方式的选择.方法 回顾性总结2001年9月至2011年6月我科47例尿道损伤患者的临床资料,分析术后并发症及排尿情况.结果 47例患者随访41例,随访时间1～84个月,术后2～6周拔除尿管；采用膀胱穿刺造瘘术3例,留置导尿8例,输尿管镜尿道置管术18例,腔镜下尿道会师术4例,尿道修补术或断端吻合术14例(术后会阴伤口感染2例,尿漏2例),术后31例排尿良好,尿道狭窄10例,失访6例.结论 前尿道不全断裂首选输尿管镜尿道置管术,不成功时行腔镜下尿道会师术,而对于前尿道断裂仍宜行尿道断端吻合术.

Clinical experience of emergency treatment of anterior urethral injury

Objective To describe our experience with the selection of early treatment of anterior urethral injury. Methods A retrospective study was performed on 47 patients who presented with traumatic injury to the anterior urethra between September 2001 and June 2011. The postoperative complications and urination conditions were analyzed. Results Forty-one cases of patients were followed up for 1 to 84 months, urinary catheter was removed at 2-6 weeks after operation; 3 of them were treated with suprapubic punctural cystostomy, 8 cases with indwelling urethral catheter, 18 cases with ureteroscopy for urethral catheterization, 4 cases with endoscopic urethral reunion, 14 cases with repair and anastomosis (postoperative perineal wound infection 2 cases, urinary leak 2 cases). Postoperative urination was satisfyirg in 31 cases, urethral stricture occurred in 10 cases, and 6 cases were lost of followed up. Conclusion Ureteroscopy for urethral catheterization should be the first choice for the treatment of anterior urethra rupture; when it is not successful, urethral reunion operation by endoscovisual activity will be selected; but for anterior urethral disruption, the repair and anastomosis method should still be taken into account.