顺行输尿管镜铥激光治疗尿道狭窄的疗效观察

目的:探讨顺行输尿管镜结合铥激光技术在治疗后尿道狭窄中的效果。方法:2例后尿道狭窄男性患者,4号尿道探子经耻骨上膀胱造瘘口,沿膀胱前壁滑入尿道内口,然后经尿道置入输尿管镜与尿道探子对接。找到尿道后,将4号输尿管导管经输尿管镜插入膀胱内,输尿管镜随后穿越狭窄段进入膀胱内。铥激光放射状切开尿道狭窄环,并切除、修整尿道内面瘢痕组织,使管腔光滑,直至顺利通过20号尿道探子。结果:2例均一次手术取得成功,拔除导尿管后患者均能自主排尿,未出现尿失禁等并发症。结论:输尿管镜结合铥激光治疗后尿道狭窄这一新技术操作安全,创伤小、并发症少,短期疗效显著。

Treatment of urethral stricture with thulium laser

Objective:To explore the efficacy of management of posterior-urethral stricture with ureteroscope and Thulium laser.Methods:Two males with posterior-urethral stricture were studed. The urethral scout(F4) was inserted into the proximal urethra through the pathway of suprapubic cystostomy to meet the ureteroscope which was inserted in the urethra retrogradely. Upon fingding the right way of the urethra, a F4 ureter catheter was inserted into the the bladder through the ureteroscope. Then, the ureteroscope was passed through the stricture part, and came into the baldder. The stenosis site was cut and the scar tissue was repaired by Thulium laser.Then make the urethra smooth so that the urethral probe (F20) could pass through the stricture part successfully.Results:The operation was performed successfully for the first time in two patients.Both of the patients could micturate normally,with no case of incontinence.Conclusions:Management of posterior-urethral stricture with Thulium laser and ureteroscope had good effect in short-term ,with small trauma and complications.