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目的:探讨输尿管镜直视下置入斑马导丝,筋膜扩张器在斑马导丝引导下治疗医源性尿道损伤狭窄的方法和疗效。方法:回顾性分析输尿管镜直视下置入斑马导丝,筋膜扩张器在斑马导丝引导下治疗医源性尿道损伤狭窄21例患者的临床资料。结果:21例患者采用该法成功施行尿道扩张,其后留置尿管,历经3~12次不等的尿道扩张,均未发生尿路感染、附睾炎、尿道大量出血、尿道穿破或假道形成等严重并发症。21例均获得随访,术后随访2~16个月,15例排尿通畅,尿线粗而有力,另6例因尿道瘢痕重、狭窄段较长需长期行尿道扩张,其中5例加行冷刀内切开、瘢痕电切术,1例行尿道成形术后治愈。结论:输尿管镜直视下置入斑马导丝,筋膜扩张器在斑马导丝引导下治疗医源性尿道损伤狭窄操作简单,成功率高,并发症少,值得临床推广。
Objective: To investigate the method and effect of ureteroscope guided placement of zebra guidewire and fascia dilator in the treatment of iatrogenic urethral stricture guided by zebra guidewire. Methods: The clinical data of 21 patients with iatrogenic urethral stricture under the guide of zebra guidewire were retrospectively analyzed. Results: Twenty-one patients underwent urethral dilatation successfully, followed by indwelling catheter. Urethral infection, epididymitis, massive urethral bleeding, urethral perforation or false passage occurred after 3 ~ 12 unenhanced urethral dilatation Formed and other serious complications. 21 cases were followed up for 2 to 16 months after operation, 15 cases of voiding patency, thick and powerful urinary tract, and the other 6 cases due to urethral stricture, stenosis required long-term urethral dilatation, of which 5 cases of cold Knife incision, scar resection, 1 case cured after urethroplasty. Conclusion: Ureteroscopic placement of zebra guidewire under direct vision, fascia dilator in zebra guidewire treatment of iatrogenic urethral stricture simple operation, high success rate, fewer complications, is worthy of clinical promotion.