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目的:探讨输尿管镜尿道会师术治疗尿道断裂的临床效果和应用价值。方法:对2008年3月~2012年3月期间我院输尿管镜尿道会师术治疗的21例男性尿道断裂患者的临床资料进行回顾性分析;镜下经尿道外口或内口向尿道断裂近侧或远侧断端放置导丝,循导丝引导留置Foley导尿管牵引固定2~4周,恢复尿道连续性,引流尿液。结果:所有手术全部成功,15例经尿道外口置管,6例联合肾镜经尿道内、外口双向置管。手术时间10~50min。术后随访6~18个月,18例排尿通畅,3例尿线变细考虑尿道狭窄,其中2例定期行尿道扩张,1例行尿道狭窄内切开后定期尿道扩张,均痊愈恢复。无感染、尿瘘、尿失禁及明显性功能障碍。结论:输尿管镜尿道会师术治疗尿道断裂创伤小、手术时间短、可视化、简便快捷、并发症少、安全有效,是一种值得推荐的微创治疗方法。
Objective: To investigate the clinical effect and application value of ureteroscopic urethral division in the treatment of urethral rupture. Methods: The clinical data of 21 cases of male urethral rupture treated by ureteroscopic urethra in our hospital from March 2008 to March 2012 were retrospectively analyzed. The transurethral or internal port of the urethra underwent urethral rupture Or the distal end of the guide wire placed staging guide wires lead indwelling Foley catheter traction for 2 to 4 weeks to restore urethral continuity, drainage of urine. Results: All the operations were successful. Fifteen patients underwent transurethral catheterization and 6 patients underwent combined ureteroscopy and ureterial bi-directional catheterization. Surgery time 10 ~ 50min. All cases were followed up for 6 to 18 months. Eighteen cases of urinary tract patency and 3 cases of urethral degeneration were considered as urethral strictures. Two cases underwent urethral dilatation regularly and one case underwent urethral dilatation after urethral stricture incision. All recovered and recovered. No infection, urinary fistula, urinary incontinence and significant sexual dysfunction. Conclusions: Ureteroscopic urethra surgery is a minimally invasive treatment which is recommended to treat urethral rupture. It is a safe and effective method to treat urethral rupture with short operative time, visualization, simple and quick operation, less complications and less complications.