输尿管镜下杆状电极腔内治疗尿道狭窄

目的 探讨输尿管镜下杆状电极腔内治疗尿道狭窄的方法，提高手术技巧。方法 联合应用输尿管镜、自制杆状电极、等离子杆状电极等经尿道治疗56例男性尿道狭窄。患者年龄3～91岁，平均51岁。其中尿道下裂术后狭窄5例，外伤致狭窄7例，长期留置尿管致炎性尿道狭窄3例，金属尿道探子尿道扩张形成假道致狭窄9例，前列腺癌根治术后狭窄5例，前列腺摘除术后狭窄8例，前列腺电切术后狭窄19例。狭窄长度0．3～6．0cm，平均2．1cm。结果 55例(98．2％)手术成功，48例1次手术成功，7例2—3次腔内手术获成功，其中尿道下裂术后者2例，复杂性尿道狭窄者5例；1例反复内切开仍存在严重尿道瘢痕者改开放手术。结论联合应用输尿管镜、自制杆状电极、等离子杆状电极等腔内治疗尿道狭窄疗效满意。

Endoscopic surgery with ureteroscope and band-form electrode for the treatment of urethral stricture

Objective To investigate a new endoscopic surgery with ureteroscope and band-form electrode for urethral stricture,and to improve the skill of endoscopic surgery. Methods Transurethral urethrotomy combined with ureteroscope and band-form electrode was carried out on 56 male patients (age range,3-91 years;mean age,51 years) with urethral stricture.Of them,5 cases had urethral stricture from hypospadias repair,7 cases from trauma,3 cases from long-term catheterization,9 cases from metal urethral probe dilation,5 cases from radical prostatectomy,8 cases from prostatectomy,19 cases from transurethral electro-resection of prostate.The length of the stricture ranged from 0.3 to 6.0 cm with a mean of 2.1 cm. Results Among the 56 patients,operation was performed successfully in 55 cases (98.2%);of the 55 cases,7 (2 with urethral stricture after hypospadias repair and 5 with complicated urethral stricture) underwent 2 or 3 endoscopic surgical treatments.The operation failed in 1 case due to serious urethral stricture, and open surgery was performed on him. Conclusions Transurethral urethrotomy combined with ureteroscope and band-form electrode may be effective for the treatment of urethral stricture.