60例尿道狭窄或闭锁的外科治疗

目的：探讨尿道狭窄或闭锁的治疗效果。方法：对60例尿道狭窄或闭锁患者的临床资料进行了回顾性分析．前尿道狭窄或闭锁25例，行开放手术11例，腔内手术14例；后尿道狭窄或闭锁35例．行开放手术12例，腔内手术23例，术后均口服维拉帕米、维生素C、维生素E治疗1～3个月。结果：25例前尿道狭窄或闭锁患者手术均获成功．排尿通畅。35例后尿道狭窄或闭锁患者，行开放手术12例中，术后排尿通畅10例．排尿困难2例，尿道造影显示尿道狭窄，其中1例后行腔内手术治愈；行腔内手术23例中，术后排尿通畅22例，排尿困难1例，尿道造影显示尿道狭窄。随访6个月～1年，58例排尿通畅，2例排尿困难．其中1例行定期尿道扩张，1例行膀胱造瘘术引流尿液。结论：术前了解尿道狭窄状况，选择适当的手术方法，充分切除或切开疤痕，积极预防感染并配合抗疤痕组织药物治疗是手术成功的重要保证。

Surgical treatment of urethral stricture and occlusion of 60 cases

Objective: To explore the effect of surgical therapy of urethrostenosis and urethratresia. Methods: Sixty patients were included in this retrospective study, 25 cases were in anterior urethra and 35 in posterior part. Open surgery was performed on 23 cases and endoscopic therapy on 37. All cases after surgery received the treatment of verapamil, vitamin E and vitamin C 1 month to 3 months. Results: All patients were followed up from 6 months to 12 months. All of the anterior urethral cases were successfully, among them, 11 cases were with open surgery and 14 with endoscopic surgery. Normal urination was achieved. Within posterior urethral stricture and occlusion situation, open surgery was in 12 cases with 10 cases of normal urination and endoscopic surgery in 23 cases with 22 cases of normal urination. 2 cases with open surgery resulted in postoperative dysuria, one of 2 cases with open surgery was successfully after endoscopic surgery. 1 case with endoscopy resulted in postoperative dysuria or anuria. Urethral stricture and occlusion were shown in all these unsuccessful operation according to our urethrogram. Conclusions: The success of the treatment depends on a few key points. Firstly,the stenosed segment of urethra should be thoroughly understood. The proper surgery should be selected. Secondly, the scar should be incised completely and resected thoroughly by electric technique. Finally, in the postoperation period,infection should be prevented and the medications of antiscar should be utilized.