复杂性尿道狭窄的诊断和外科治疗

目的：提高复杂性尿道狭窄的诊断水平和治疗效果。方法：诊断采用膀胱尿道造影，经直肠尿道超声。治疗采用经会阴耻骨联合途径的尿道端端吻合术，游离颊粘膜，膀胱粘膜及带蒂包皮内板，纵隔阴囊皮瓣代尿道一期尿道成形术，女性尿道闭锁采用双阴唇带蒂皮瓣尿道成形术。结果：32例患者，术后25例排尿通畅，5例排尿不畅，2例失败。结论：膀胱尿道造影结合经直肠尿道B超是确诊尿道狭窄或闭锁严重程度的重要手段。根据不同病情选用不同的手术方法有利于复杂性尿道狭窄的治疗。

Diagnosis and surgical treatment of complex urethral stricture

Purpose: To improve the diagnosis and treatment of complex urethral stricture. Method; Diagnosis methods included cystourethrography,transrectal sonourethrography. Treatment programs included perineal repair or combined transpubic and perineal urethroplasty, one-stage free buccal mucosa, bladder mucosa and pedicled pre-putial patch, mediastinum scrotal flap urethroplasty. For atreturethria in female we used one-stage pedicled labial patch urethroplasty. Result; In 32 patients,25 patients had good voiding,5 patients had dysuria and 2 failure. Conclusion; Combined cystourethrography and transrectal sonourethrography could make a definitive diagnosis of urethral stricture. Depending on different patient's pathological condition, a suitable surgical method should be selected to be performed so as to obtain the best surgical results.