腔内尿道会师法治疗复杂性男性尿道狭窄

目的总结腔内尿道会师法治疗复杂性尿道狭窄的经验。方法16例男性复杂性尿道狭窄患者,术前行耻骨上膀胱造瘘术,硬膜外麻醉下经尿道外口置入尿道内切开镜,经耻骨上膀胱造瘘口置入一软性膀胱镜经膀胱颈口顺行进入尿道。经内切开镜或软性膀胱镜插入一细输尿管导管,经正道通过狭窄段尿道。沿此导管用内切开刀切开狭窄段尿道,沿正道进入膀胱,再用Otis刀彻底切开狭窄段。结果16例患者均成功地顺利完成了腔内尿道会师手术,拔除尿管后排尿通畅。平均手术时间122min。平均最大尿流率18mL/s。随访15月,F20尿道扩张器可以顺利通过。结论利用内切开镜和软性膀胱镜腔内尿道会师治疗复杂性尿道狭窄,方法简单易行,疗效确切可靠,成功率高。

Treatment of complex male urethral stricture by endourethral reunion operation

Objective To summarize the experiences of treatment of complex male urethral stricture by endourethral reunion operation. Methods 16 patients with complex urethral stricture were preformed suprapubic cystostomy before operation. The internal urethrotom and soft cystoscope were put into the urethra external and internal aperture respectively, a ureteral catheter was inserted through the stricture urethra from the endoscope, and then the stricture urethra along the ureteral catheter to the bladder was slit by the urethrotome and Otis-urethrotom. Results The operations were successfully preformed in 16 patients. Average operative time was 122 min, and maximum urine flow rate was 18 mL/s. Conclusion Endourethral reunion operation is easy to do and has good results for complex urethral stricture.