复杂性后尿道狭窄的手术径路探讨

目的：总结各种复杂性后尿道狭窄手术径路的应用经验，提高复杂性后尿道狭窄的治疗效果。方法：对72例复杂性后尿道狭窄患者的手术径路进行回顾性分析。结果：64例（89％）一次手术成功，经会阴径路中采用单纯经会阴径路34例中治愈31例（91％），经会阴耻骨下缘径路14例中治愈13例（93％），经耻骨径路中采用单纯经耻骨径路6例中治愈4例（67％），经耻骨联合会阴径路18例中治愈16例（89％0，41例长段后尿道狭窄（＞3cm)者治愈35例（85％），18例有合并症者治愈17例（94％例）。结论：复杂性后尿道狭窄的各种手术径路均存在一定的优缺点，选择合适的手术径路应综合多种因素考虑，经会阴径路因操作简单，创伤小，并发症少，仍是目前首选的手术径路。

Evaluation of the surgical approach in the operation management of com plex posterior urethral stricture

Objective To present the preliminary experience on the operative approach in the surgical management of complex posterior urethral stricture. Methods The operative approach of 72 cases of complex posterior urethral stricture was reviewed. Results The total success rate was 89%(64/72). 34 cases were operated with simlpe transperineal approach and the success was rate 91%, transperineal inferior pubic approach was adopted in 14 and the success rate was 93%;simple transpubic approach was conducted in 6 with a success rate of 67% and transpubic perineal approach in 18 with a success rate of 89%. 41 cases with long posterior urethral stricture were operated with a success rate of 85% and 18 cases with complication with a success rate of 94%. Conclusions Each operative approach has it own advantages and disadvantages.Transperineal approach is preferred because the procedure is simpler,less traumatic with less occurrence of complication.