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目的研究治疗良性前列腺增生术后复杂性前尿道狭窄的新手术——直径匹配性递增性尿道内切开术的疗效和安全性。方法自2004年1月至2007年7月,对确诊的39例患者(前尿道均不能通过12F尿道探条)行直径匹配性递增性尿道内切开术,用小号尿道内切开镜切开最狭窄段尿道,中号尿道内切开镜切开次狭窄段和次正常段尿道,术后配合尿道扩张和相应药物治疗以抑制瘢痕生成。结果39例患者术后随访4～30个月,最终35例治愈(89.7%),可通过20～24F尿道探子,排泄性膀胱尿道造影显示尿道恢复通畅,最大尿流率(maximum flow rate,Qmaxx)为15.5～39.8ml/s,平均(23.4±6.7)ml/s;3例好转,能通过16～18F尿道探子,Qmax分别为11.2、11.9和14.8ml/s;1例失败,先后经历3次手术,仍不能自行排尿。结论直径匹配性递增性尿道内切开术是治疗良性前列腺增生术后复杂性前尿道狭窄的一种较好的方法。
Objective To study the efficacy and safety of a new operation for the treatment of complicated anterior urethral stricture after benign prostatic hyperplasia (diameter-matched incremental urethrotomy). Methods From January 2004 to July 2007, 39 patients diagnosed (the former urethra could not pass the 12F urethral probe) were matched with diameter matching urethrotomy. Open the narrowest urethra, the middle urethrotomy incision open the second stenosis and the next section of the normal urethra, urethral dilation and the corresponding drug treatment to inhibit the formation of scar. Results 39 patients were followed up for 4 to 30 months, and the final 35 cases were cured (89.7%). Urethral urethral mapping with 20 ~ 24F urethral catheterization and urinary bladder urethra showed normal urethral recovery, maximum flow rate (Qmaxx ) Was 15.5-39.8ml / s, with an average of (23.4 ± 6.7) ml / s. Three cases improved and passed the 16-18F urethral probe with Qmax of 11.2, 11.9 and 14.8ml / s, respectively. Secondary surgery, still can not urinate. Conclusions Increasing diameter matching urethrotomy is a good way to treat complicated anterior urethral stricture after benign prostatic hyperplasia.