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在尿道损伤,经会阴修补术中,切开会阴部,显露断裂的近端尿道。尤其后尿道完全断裂,由于近端内缩,并有周围组织挫伤、出血,无法寻找其近端,从而不能将导尿管插入膀胱。如盲目探查,会加重海绵体及组织损伤,引起出血,损伤尿道。因而常需经耻骨联合上切开膀胱,经膀胱插探子于后尿道,显露尿道近端,借以引导尿管于膀胱内,从而进行尿道吻合,增加了手术范围及创伤,给伤员造成更大痛苦。有人提出,按压下腹部刺激排尿,协助寻找近端。此法不易成功。我们采取了前列腺挤压法,借助于前列腺液排出,寻找近端,易成功。其理由是:
In the urethral injury, perineal prosthesis, incision perineal, revealing the proximal rupture of the urethra. In particular, the posterior urethra is completely ruptured. Due to proximal retraction, contusion and bleeding from the surrounding tissue, the proximal end can not be searched and the urinary catheter can not be inserted into the bladder. Such as blind exploration, will increase the sponge and tissue damage, causing bleeding, damage to the urethra. Therefore, it is often necessary to incise the bladder via the pubic symphysis. The bladder is inserted into the posterior urethra to reveal the proximal urethra so that the urethra can be guided into the bladder for an anastomosis of the urethra, which increases the surgical field and trauma and causes more pain to the wounded . It was suggested that pressing the lower abdomen to stimulate urination, to help find the proximal. This method is not easy to succeed. We have taken the prostate extrusion method, with the help of prostatic fluid excretion, looking for the proximal end, easy to succeed. The reason is: