输尿管镜下尿道置管会师术治疗尿道断裂八例

目的探讨输尿管镜下行尿道置管会师术治疗尿道断裂的临床效果和使用价值。方法对2008年10月至2011年2月间经输尿管镜下行尿道置管会师术治疗尿道断裂的病例进行回顾性分析;输尿管镜下经尿道外或内口置入导丝至膀胱,再经导丝引导插入Foley导尿管牵引固定,引流尿液2～4周后拔管。结果 8例全部手术成功,7例经尿道外口置管,另1例经尿道内、外口双向置管。前尿道不完全断裂2例,后尿道完全断裂6例。手术时间10～45min。术后随访6～12个月,6例排尿通畅,2例因尿线变细疑有尿道瘢痕狭窄定期行尿道扩张后痊愈,无尿瘘、假道、尿失禁和明显性功能障碍。结论输尿管镜下尿道置管会师术操作简单、手术时间短、对患者创伤小、术后恢复快、效果确切、并发症少。可同时解除尿潴留并恢复尿道连续性,适合各种生命体征平稳的尿道断裂的早期治疗,值得临床推广。

Ureteroscopy urethral catheter realignment for urethral rupture in 8 cases

Objective To discuss the clinical effect and application value of ureteroscope urethral catheter realignment for the treatment of urethral rupture.Methods Retrospectively analyze the urethral rupture records treated by ureteroscopy urethral catheter realignment from October 2008 to February 2011.Place guide wire to the bladder from external or internal orifice of urethra by ureteroscopy,insert Foley catheter along the guide wire,then the Foley catheter was towed and fixed.Finally,extubae Foley catheter after drainage of urine 2 to 4 weeks.Results All 8 patients were successfully operated,7 cases were catheterized from external urethral orifice,the other 1 cases was catheterized by both external and internal urethral orifice two-way pipe.Anterior urethra incomplete ruptured in 2 cases,6 cases of posterior urethral complete ruptured.The operation time was 10-45 min.All the patients were followed up for 6-12 months,6 patients urinate unobstructed,2 cases with urethral stricture urinate well after regular urethral dilatation.No fistula,false passage,urinary incontinence or obvious sexual dysfunction happened.Conclusions Ureteroscopy urethral catheter realignment for urethral rupture is a minimally invasive,simple,safe and effective method due to its shorter operation time,less trauma and quicker recovery.It can relieved uroschesis and restore the continuity of the urinary tract at the same time.It is suitable for all kinds of vital signs stable urethral ruptured patients in the early treatment,and is worthy of clinical application.