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目的探讨早期内窥镜尿道内会师治疗创伤性后尿道断裂的临床应用价值。 方法 采用耻骨上膀胱镜和膀胱尿道镜窥视下于尿道断端会师。自膀胱镜向下插入输尿管导管,经尿道镜将其引出尿道外口,再由输尿管导管将18F硅胶气囊导尿管引入膀胱。 结果 11例创伤性后尿道断裂在内窥镜直视下尿道内会师均获成功,所有病例无尿失禁,其中9例维持性功能。随访2~3年,3例无需进一步处理,尿流率正常。另8例出现短程继发性尿道狭窄,经1-2次尿道内切开后排尿正常。结论 早期内窥镜尿道内会师治疗外伤性后尿道完全断裂具有安全、快速和无创等优点;并能降低由于阴部神经损伤所致的阳萎发生率。
Objective To investigate the clinical value of early endoscopic urethral in-patient treatment of traumatic posterior urethral rupture. Methods Using suprapubic cystoscopy and urinary bladder urethra under peep at the end of the urethra meeting. From the cystoscope down into the ureteral catheter, the urethral catheter will be led out of the urethral orifice, and ureteral catheter 18F silicone balloon catheter into the bladder. Results Totally 11 cases of traumatic posterior urethral rupture were successfully treated in the urethra under endoscopy, all cases had no urinary incontinence, of which 9 cases maintained sexual function. Follow-up 2 to 3 years, 3 cases without further treatment, normal urinary flow rate. The other 8 cases of short-range secondary urethral stricture, 1-2 times after urethral incision urination normal. Conclusion Early endoscopic urethrrectomy for the treatment of traumatic posterior urethra complete fracture is safe, rapid and noninvasive advantages; and can reduce the incidence of impotence due to genital nerve injury.