输尿管镜下尿道会师术治疗尿道骑跨伤体会

目的 探讨输尿管镜下尿道会师术治疗尿道骑跨伤的临床价值.方法 对17例尿道骑跨伤患者采用输尿管镜引导放置导尿管,随访观察手术的效果.结果 17例中,3例因尿道完全断裂,镜下会师失败后,2例改行开放会师术,1例行耻骨上膀胱穿刺造瘘术;其余14例采用输尿管镜下尿道会师术均1次成功.术后均获随访 0.5~1年,除2例排尿明显变细、需定期尿道扩张外,其余患者未出现尿道狭窄、尿失禁、性功能障碍等并发症.结论 输尿管镜下尿道会师术手术时间短、创伤小、恢复快、效果好,是治疗尿道骑跨伤的有效方法.

Treatment of urethral straddle injury by ureteroscopic urethral realignment

Objective To investigate clinical value of ureteroscopic urethral realignment in the treatment of urethral straddle injury. Methods Catheter was placed under the guidance of ureteroscope in 17 patients with urethral straddles injury. The follow-up was carried out to observe the therapeutic effects. Results Among the 17 cases,3 cases had urethral complete break which led to the failure of microscopic realignment. Two of they were switched to the open ureteroscopic realignment, and the other one received the suprapubic puncture fistulation. Ureteroscopic realignment was successfully performed at one time in the other 14 cases. The postoperative follow-up was made in all the cases for 0.5-1 year. Except that 2 patients had the emiction thinningzed and needed regular urethral sounding, the other ones did not have any complications such as urethral stricture, urinary incontinence, and sexual dysfunction, etc. Conclusion Ureteroscopic realignment had shorter operation time, smaller trauma, faster recovery, and better effect and is an effective treatment on urethral straddle injury.