细输尿管镜联合筋膜扩张器在治疗尿道下裂术后尿道狭窄中的应用

目的探讨细输尿管镜联合筋膜扩张器在尿道下裂术后尿道狭窄治疗中的临床疗效。方法回顾性分析14例尿道下裂术后尿道狭窄患儿,用F5/7.6输尿管镜直视下将斑马导丝通过狭窄段尿道置入膀胱,在其引导下选择适宜的筋膜扩张器依次递增扩张尿道,其后留置尿管,并定期随访。结果本组14例患者均成功完成尿道扩张,拔除尿管后排尿通畅、尿线粗,最大尿流率明显提高,无假道形成、尿瘘、尿失禁等并发症出现。结论细输尿管镜联合筋膜扩张器治疗尿道下裂术后尿道狭窄具有创伤性小、安全性高、疗效确切、可重复性等优点,值得推广。

Application of the ureteroscope combined with fasciai dilator for the treatment of urethral stricture after hypospadias

Objective To evaluate the clinical efficacy and safety of ureteroscope combined with faseial dilator for the treatment of urethral stricture after hypospadias. Methods Clinical data of 14 patients underwent ureteroscope combined with fascial dilators for the treatment of urethral stricture after hypospadias were ana- lyzed. Under basal anesthesia, the urethra explored direct vision with F5/7.6 ureteroscope, and implanted ze- bra guidewire through ureteroscope, then gradual expanded with fascial dilator, and indwelled the right size catheter. Results All the operations were successful. All cases satisfied with their urination after catheter re- moval, and maximum urinary flow rate obviously improved. No serious complications of the false way form, urina- ry fistula and urinary incontinence were occurred. Among them,6 cases needed periodic dilation during a follow up for 6 month-2 year post-operatively. Conclusion The ureteroscope combined with fascial dilator for the treatment of urethral stricture after hypospadias is good treatment method with small damage, high safety, cer- tain short-term effect and repeatability, worthy of clinical application.