“直径匹配性递增性尿道内切开术”治疗前列腺术后 - 第三军医大学学报.doc

编号：200905009 刊用形式： 文章编号： 直径匹配性递增性尿道内切开术治疗前列腺术后复杂性前尿道狭窄39例的临床分析 张家华 谢小燕 周占松 吴小军 宋彩萍 周远秀 季惠翔 （第三军医大学西南医 摘 要：目的 前瞻性研究治疗良性前列腺增生术后复杂性前尿道狭窄的新手术直径匹配性递增性尿道内切开术的疗效和安全性。方法 自2004年1月2007年7月，对确诊的39例患者前尿道均不能通过12F尿道探条行直径匹配性递增性尿道内切开术，术后配合尿道扩张和相应药物治疗以抑制瘢痕生成。结果39例患者术4～30个月，最终35例治愈（89.7%），可通过20~24F尿道探子，排泄性膀胱尿道造影显示尿道恢复通畅， Qmaxx）为15.5~39.8 ml/s，平均23.4±6.7）ml/s s；3例好转，能通过16～18F尿道探子，Qmax分别为11.2和14.8 ml/s；1例失败，先后经历3次手术，仍不能自行排尿。结论 直径匹配性递增性尿道内切开术是治疗良性前列腺增生术后复杂性前尿道狭窄的一种较好的方法。 良性前列腺增生症 尿道狭窄 手术of “diameter-matched and increasing internal urethrotomy” treating complicated anterior urethral stricture after benign prostate hyperplasia surgery Jiahua Zhang, Xiaoyan Xie, Zhansong Zhou, Xiaojun Wu, Caiping Song and Yuanxiu Zhou, Huixiang Ji （Department of Urinary Surgery, Southwest Hospital, The Third Military Medical University，chongqin 400038，China） Abstract: Objective To summary and evaluate a new operation, “diameter-matched and increasing internal urethrotomy”, for the complicated anterior urethral stricture after benign prostate hyperplasia surgery. Methods From January 2004 to Jluy 2007, 39 definitely diagnosed patients underwent diameter-matched internal urethrotomy. First, the worst stricture segment of urethra was incised by little resectoscope for urethrotomy , moderate stricture segments on both side and two lateral subnormal segments of urethrea were incised by middle resectoscope for urethrotomy ,and urethral sounding and some medicine were used to prevent the urethral scar formation. Results Urethral circumference of all patients was under 12F before operation, 35 patients cured (89.7%) after operation, and 20-24F urethral sounds can pass through their urethra, their mean Qmax was 23.4ml/s; the urethral strictures of 3 patients was improved, only 16-18F urethral sounds can pass through their urethra and the Qmax were