膀胱尿道环形管在治疗男性后尿道损伤和狭窄中的应用

目的探讨应用膀胱尿道环形管治疗男性后尿道断裂和狭窄手术的效果.方法对62例后尿道断裂者行尿道会师牵引术,79例创伤性后尿道狭窄者行开放性尿道成形术,术后用细塑料管、血管造影用导丝套管或输尿管导管作环形管,在环形管和丝状探条引导下用24号金属跟随器定期扩张尿道,扩张间期1个月,尿流正常,拔除环形管.结果124例(87.9%)获得随访,尿道会师牵引术治愈率94.6%,各种尿道成形术治愈率92.6%,带管扩张期间未发生新的尿道损伤.19例带管期间有尿道刺激症状,其中塑料管组9例(13.8%),套管组1例(4.2%),输尿管导管组7例(20.0%).结论环形管引导下尿道扩张避免了尿道扩张的盲目性,能巩固和提高尿道会师牵引术和尿道成形术的疗效.血管造影用导丝套管是较为适宜的环形管.

APPLICATION OF VESICOURETHRAL O-SHAPPED TUBE IN THE TREATMENT FOR POSTERIOR URETHRAL INJURY AND STRICTURE IN MALE

Objective:To improve the surgical management for posterior urethral disruption and stricture with traumas in male.Methods:Sixty two cases of posterior urethral disruption and 79 cases of posterior urethral stricture with traumas were operated.A fine plastic tube,angiographic cannula or ureteral catheter was employed as a O shapped tube after urethral realignment with traction and urethroplasty,within which a filiform was inserted to guide a 24F metal follower to dilate the urethral regularly.Once the interval was beyond 1 month with normal urinary flow rate,the O shapped tube then was removed.Results:One hundred and twenty four cases(87.9%)were followed up.The cure rates of urethral realignment with traction and urethroplasty were 94.6% and 92.6% respectively,no additional urethral injury happened during the dilation.Seventeen cases had urethral stimulant symptom during using the O shapped tube,9(13.8%) of them in plastic tube,1(4.2%)in angiographic cannula and 7(20.0%)in ureteral catheter.Conclusion:Urethral dilatation guided by the O shapped tube can avoid the aimlissness of dilatation postoperatively and significantly improve the success rate of urethral realignment with traction and urethroplasty.The angiographic cannula is suitable to be used as a O shapped tube.