尿道会师导引装置在尿道狭窄与闭锁的腔内手术中的应用：附视频

目的 探索在治疗尿道狭窄与闭锁的腔内手术中应用尿道会师导引装置的可行性和安全性.方法 深圳市第八人民医院自2008年1月至2012年8月,对25例后尿道狭窄和闭锁患者行腔内切开手术,其中11例应用尿道会师导引杆置入后尿道指引金属导丝穿刺通过瘢痕尿道,在导丝引导下行尿道腔内狭窄切开和瘢痕切除术,术后留置导尿管3～6周,拔管后行定期尿道扩张,现对其临床资料行回顾性分析.结果 25例腔内手术均一次成功,无中转开放手术.手术时间35～86 min,术中出血量5～25ml.20例拔尿管后排尿正常,5例排尿不畅,拔管后扩张尿道4～12次后排尿正常,出院1个月后复查尿流率,最大尿流率（Qmax）为（16.0±3.5） ml/s.术后无一例尿失禁.结论 将尿道会师导引装置应用于治疗尿道闭锁和狭窄的腔内手术中有利于引导金属导丝跨越尿道瘢痕,操作安全可靠,简便易行.

Urethral guidance device used in the endourethral surgery for urethrostenosis and urethratresia

Objective To investigate the feasibility and the safety of urethral guidance device in the endourethral surgery for urethrostenosis and urethratresia.Methods Form January 2008 to August 2012,in the Eighth People＇s Hospital of Shenzhen 11 cases among 25 cases suffered fiom urethrostenosis or urethratresia,urethral guidance probe was plugged into posterior urethra to lead a metal guide wire puncturing through urethral scar for endourethral surgery such as urethrotomy and transurethral scar resection.Every case had a catheterization for 3-6 weeks after operation and 4-12 procedures regular urethral dilation after removing catheter.The clinical data were analyzed retrospectively.Results All 25 cases of endourethral operation were successfully managed with less bleeding.The duration of procedure was 35-86 min.All cases didn＇t need to cut bladder.20 cases had good voiding after removing catheter,5 cases had dysuria and gradually got normal voiding after 4-12 procedures of regular urethral dilation,maximum urine flow of all cases were （16.0±3.5） ml/s after hospital discharge one month.Conclusion Urethral guidance device used in the endourethral surgery for urethrostenosis and urethratresia is helpful for leading a metal guide wire to get through the scar urethra,avoiding injury of urethra,rectum and bladder.