冷刀联合钬激光尿道内切开术治疗尿道狭窄

目的探讨冷刀联合钬激光尿道内切开术治疗尿道狭窄的安全性和有效性。方法总结分析我院2009年3月～2012年3月收治男性尿道狭窄36例的临床资料。前尿道狭窄7例,后尿道狭窄29例(包括尿道完全闭锁3例)。狭窄或者闭锁长度0.5～1.5 cm。结果本组36例手术均顺利完成,均一期行留置F18～F20导尿管2～8周。随访6个月～1年均排尿通畅,期间F18～F20尿道探子尿道扩张顺利。无术中大出血、直肠损伤、术后尿瘘、尿失禁等并发症。结论冷刀联合钬激光内切开术治疗短段尿道狭窄是安全有效的,并发症少,住院时间短,早期疗效良好,但远期效果尚待观察。

Cold knife urethrotomy combined with endoscopic holmium laser resection in treatment of urethral stricture

Objective To explore the clinical efficacy and safety of cold knife urethrotomy combined with endoscopic holmium laser resection in treatment of urethral stricture.Methods Clinical data of 36 male patients with urethral stricture having undergone cold knife urethrotomy combined with endoscopic holmium laser resection from March 2009 to March 2012 were analyzed retrospectively.Of the 36 cases were 7 cases of anterior urethral stricture and 29 cases of posterior urethral stricture（including 3 cases of urethral atresia）.The length of the stricture or atresia ranged from 0.5cm to 1.5 cm.Results The operation was successful in all the 36 cases.Foley catheters were indwelled for 2 to 8 weeks.All patients were followed up for 6 to 12 months.Smooth urination was achieved after catheter indwelling.No complications such as massive hemorrhage during surgery,rectal injury,urinary incontinence,and urinary fistula were found.Conclusion Cold knife urethrotomy combined with endoscopic holmium laser resection in treatment of urethral stricture is a safe and effective minimally invasive option for short urethral stricture,which also has the advantages of easier operation and fewer complications.Its short-term outcome is satisfactory,but its long-term effect remains to be further observed.