提高经会阴后尿道端端吻合术成功率的探讨(附76例报告)

张明; 何恢绪; 王海坤; 肖耀军; 黄谷

提高经会阴后尿道端端吻合术成功率的探讨(附76例报告)

- 1. 武警广东省总队医院泌尿外科(广州, 510507);
- 2. 广州军区总医院泌尿外科

详细信息

通讯作者: 张明,E-mail:drzhangming1962@163.com

中图分类号: R694

收稿日期: 2012-03-21

Investigate transperineal terminoterminal anastomosis for posterior urethral stricture (Report of 76 cases)

- 1. Department of Urology, Guangdong Provincial Corps Hospital, Chinese People's Armed Police Forces, Guangzhou, 510507, China;
- 2. Department of Urology, Guangzhou Military Hospital

More Information

Corresponding author: ZHANG Ming, E-mail: drzhangming1962@163.com

Received Date: 21 March 2012

摘要

摘要: 总结经会阴后尿道狭窄/闭锁瘢痕切除+端端吻合术的临床经验，提高一次手术成功率。方法：经会阴后尿道狭窄/闭锁瘢痕切除+端端吻合术治疗骨盆骨折所致尿道损伤继发后尿道狭窄/闭锁患者76例。对于<3 cm短段狭窄/闭锁者，釆用经会阴手术入路，彻底切除瘢痕，作无张力、大口径、精确吻合；对于>3 cm的狭窄/闭锁者，釆用充分游离前尿道，切开阴茎海绵体间隔等辅助方法处理，以缩小尿道断端间距；术中留置后尿道U形支架管，木后持续支撑、软扩张吻合口。结果：76例均手术成功。72例（94.7%）术后膀胱尿道造影示后尿道通畅，尿流率正常。出现短暂性尿失禁8例，无永久性尿失禁。结论：经会阴瘢痕切除+端端吻合术治疗后尿道狭窄/闭锁成功率高；较长时间留置后尿道U形支架管，持续支撑、软扩张吻合口是防止狭窄复发的好方法。
- 尿道狭窄 /
- 尿道成形术 /
- U形支架
Abstract: Objective: To evaluate the therapeutic result of posterior urethral stricture or atresia and improve the success rate of an operation.Methods: Transperineal approach completely resected scar and accurately anastomosed urethra with no tension and large diameter.To long segment stenosis or atresia,urethrourethal anastomosis was performed after reduced broken part distance by the auxiliary treatment,as fully freeing the anterior urethra and cutting the cavernous body interval of penis.Indwelled U-shaped stent in the posterior urethra when finishing,which continuely supportting and flexibly dilating anastomotic.Results: All the surgery were successful. 72 patients (94.7%) were examined with cystourethrography to have normal voiding function after catheter removed,8 cases were suffered with provisionality incontinence, no permanent incontinence.Conclusions: Transperineal approach resection scar and terminoterminal anastomosis has high achievement ratio for the management of posterior urethral stenosis or atresia.If longer indwelling flexible U-shaped stent in the posterior urethra,which may support and dilate anastomotic,it is an effective resolution to prevent the recurrence of urethral stricture.
- urethralstricture /
- urethroplasty /
- U-shaped stent

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参考文献(5)

[1]	DANIELA E,ANTHONY R. What is the best technique for technique for urethroplasty[J]? Eur Urol, 2008, 54:1031-1041.
[2]	KORAITIM M M. On the art of anastomotic posterior urethro-plasty:a 27-yearexperience[J]. J Urol, 2005, 173:135-139.
[3]	何恢绪,吕军,李清荣,等. 耻骨下部分切除修复复杂性外伤性后尿道闭锁[J]. 中华泌尿外科杂志,1997,18(6):365-366.
[4]	胡卫列,何恢绪,曹启友,等. U形多孔支架管在复杂性后尿道手术中的应用[J]. 第一军医大学学报,2003,23:932-933.
[5]	MICHEI E, RANIERI A, PERACCHUA G, et al. End-to-end urethroplasty;long-term results[J]. BJU International, 2002, 90:68-71.