尿道狭窄手术方式与术后复发

目的选择尿道狭窄最佳治疗方法，减少术后复发。方法回顾经尿道瘢痕切除治疗男性尿道狭窄患者21例，按尿道狭窄长度分为A组（≤1．0cm）和B组（〉1．0cm），比较两组患者术中出血量、手术时间、术后最大尿流和术后复发率。结果21例手术中瘢痕彻底切除，尿道均扩张至26F。两组出血量、手术时间和术后最大尿流间比较差异无统计学意义（P〉0．05）；术后除B组1例失访外，其余20例随访3～36个月；有8例（40．0％）复发，其中A组复发1例（11．1％），B组复发7例（63．6％）（P〈0．05）。结论尿道狭窄长度≤1．0cm，内腔镜手术复发率低；狭窄长度〉1．0cm，应行尿道成形术。

Surgical methods of urethral stricture and postoperative recurrence

Objective To explore the best surgical method for urethral stricture in order to reduce postoperative recurrence. Methods Clinical data of 21 patients with urethral stricture treated by transurethral scar excision was retrospectively analyzed.The patients were divided into group A （ ≤ 1.0 cm） and group B （ 〉 1.0 cm） based on their urethral stricture length and compared in blood loss, operative duration, postoperative maximum urine flow and postoperative recurrence. Results The scars of 21 patients were completely removed and urinary tracts were dilated to 26F.There was no significant difference in blood loss, operative duration and postoperative maximum urine flow in two groups （P 〉 0.05）. The other 20 patients were followed up for 3 to 36 months other than 1 case in group B.Urethral stricture reoccurred in 8 patients with 1 case in group A （11.1%） and 7 cases in group B （63.3%） （P 〈 0.05）. Conclusion The postoperative recurrence rate is lower with ureteroscopic surgery when the length of urethral stricture is no more than 1.0 cm; the urethroplasty should be performed when the length of urethral stricture is beyond 1.0 cm.