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目的:探讨输尿管镜下尿道会师术治疗尿道骑跨伤的手术技巧。方法:对15例尿道骑跨伤患者采用输尿管镜下尿道会师术,并随访观察手术效果。结果:14例一次手术置管成功,平均手术时间8.9min,1例失败,行开放手术。术后12例患者拔出尿管后排尿通畅,随访6～12个月,无尿道狭窄发生。3例术后3个月发生尿道狭窄,经过3～6个月的尿道扩张,排尿正常,随访1年,无再狭窄发生。结论:输尿管镜下尿道会师术宜作为尿道骑跨伤的首选治疗方法,诊断性导尿可以放弃,以尿道前壁正常黏膜位为标识是成功的关键。
Objective: To investigate the urethral urethral instrumentation for the treatment of urethral injury during traumatic surgery. Methods: Fifteen patients with urethral traumatic injuries were treated with ureteroscopic urethral mastectomy and the follow-up results were observed. Results: The operation of 14 cases was successful in one operation. The average operation time was 8.9 minutes. One case failed. The patients underwent open surgery. Postoperative 12 patients after removal of the catheter urinary tract patency, follow-up of 6 to 12 months, no urethral stricture. Three cases of urethral stricture occurred 3 months after surgery. After 3 to 6 months of urethral dilatation, urination was normal, followed up for 1 year without any restenosis. Conclusion: Ureteroscopic urethral instrumentation should be the preferred method of urethral traumatic injury. Diagnostic catheterization can be abandoned. The identification of the normal mucosa of the anterior urethra is the key to success.