经会阴改良直针吻合法治疗外伤性复杂性后尿道狭窄

目的:探讨复杂性后尿道狭窄的手术方法,以进一步提高治疗效果。方法:回顾性分析经会阴切口改良直针吻合法治疗外伤性复杂性后尿道狭窄58例临床资料。结果:所有病例拔管后均能通畅排尿,随访0.5～3年,远期再狭窄4例,无其他严重并发症。结论:经会阴切口可彻底切除狭窄、闭锁的尿道,并给予良好的对端吻合,这仍是目前治疗后尿道狭窄的重要的手术方法。改良直针能克服术野深、狭小、不易吻合的困难,使尿道断端对合良好。

The surgical treatment of complex posterior urethral stricture from trauma with improved straight needle and perineum incision

Objective:To discuss and improve the surgical treatment of complex posterior urethral stricture.Methods:The clinical data of 58 patients with complex posterior urethral stricture from trauma were analyzed retrospectively,who underwent the surgical treatment with improved straight needle and perineum incision.Results:All patients could urinate smoothly after catheter was removed and were followed up from 0.5~3 years. There were no other serious complications except that long dated narrowing of 4 patients.Conclusions:The urethra with stricture or atresia could be excised thoroughly and anastomosed end to end well with combined application of abdomen and perineum incisions. The surgical treatment with perineum incision was important and unsubstitutable approach for posterior urethral stricture. It was helpful to anastomose the ends of urethra with self-made and improved straight needle without the difficulties from deep and narrow operation area.