小儿前尿道瓣膜诊治11例

目的探讨小儿前尿道瓣膜的治疗方法及临床疗效。方法回顾性分析2003年1月至2013年5月作者收治的11例前尿道瓣膜患儿临床资料,患儿均为男性,年龄3个月至8岁,平均2岁8个月,其中年龄1岁以下6例。8例使用7.5F或9F膀胱尿道镜在尿道的4点、6点和8点处切开瓣膜,并留置导尿管10 d。对其中3例合并前尿道憩室的患儿,2例行憩室切除、尿道成形术;1例一期行膀胱造瘘术,二期行憩室切除、尿道成形术。结果 11例均手术顺利,术后均排尿通畅。无尿瘘及尿道海绵体损伤。随访3个月至4年,平均1.5年。尿白细胞消失,阴茎阴囊交界处包块消失。合并肾积水2例,膀胱输尿管反流3例,B超复查均有不同程度缓解。肾功能检查血清尿素、肌酐均正常。结论腔内冷刀切开治疗前尿道瓣膜症是一种可行的方法,疗效确切,术后并发症少,预后好。合并前尿道憩室患儿可选择憩室切除、尿道成形术。

Clinical analysis of treatment of anterior urethral valves in children

Objetive To investigate the treatment and clinical efficacy of anterior urethral valves in chil-dren. Methods 11 cases range from 3 month to 8 year with mean age 32 month with anterior urethral valves in our department were analyzed retrospectively from Jan 2003 to May 2013.Eight of them were cut valves u-sing 7.5F or 9F cystourethroscopy at 4:00,6:00 and 8:00 point of the urethra.And the catheter was to be kept 10 days.Three of them combined anterior urethral diverticulum,two patients were treated of the operation diver-ticulum resection and urethroplasty,one patient was treated of the operation diverticulum resection and urethro-plasty after the cystostomy. Results All operations were successful.All patients urinated normally without u-rethral fistula and spongiosum injury.Follow-up of 3 months to 4 years average 1.5 years,leukocytes in urine disappear.The mass was disappearing between penis and scrotum.Tow patients have hydronephrosis and three patients have vesicoureteral reflux.Hydronephrosis and vesicoureteral reflux was relieved than before.Serum u-rea and creatinine were normal. Conclusions Cutting valves using cystourethroscopy is a viable method to treat anterior urethral valves with exact effect fewer complications and good prognosis.Diverticulum resection and urethroplasty is a good choice to the patient who was suffering anterior urethral valves combined anterior u-rethral diverticulum.