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目的探索尿道海绵体非离断尿道吻合术治疗骨盆骨折引起的后尿道狭窄(包括闭锁)的手术效果。方法本研究共19例骨盆骨折引起的后尿道狭窄患者,采用尿道海绵体非离断尿道吻合术重建尿道,以保护阴茎和尿道海绵体的血供免受损伤;随访6个月后,通过尿流率、尿道造影及夜间阴茎勃起(NPT)监测结果对手术效果进行评估。结果术后随访,1例患者拔管后出现排尿困难,行尿道内切开后好转,其余患者均排尿通畅,无狭窄复发;NPT监测结果显示勃起功能术前、术后无明显差异。结论对于适合的后尿道狭窄患者,应用尿道海绵体非离断尿道吻合术效果确切,能够在一定程度上减少手术因素对于阴茎和尿道海绵体血供的损伤。
Objective To explore the operative effect of urethral sponge non-interrupted urethral anastomosis in the treatment of posterior urethral stricture (including atresia) caused by pelvic fractures. Methods In this study, a total of 19 patients with posterior urethral stricture caused by pelvic fractures were treated with urethral sponge non-interrupted urethral anastomosis to reconstruct the urethra to protect the blood supply of the penis and urethra sponges from injury. After 6 months of follow-up, Flow rates, urethroscopy, and nocturnal penile erection (NPT) monitoring were used to assess the effect of the procedure. Results Postoperative follow-up, one patient had dysuria after extubation. The patients underwent urethral incision and recovered. The other patients had clear urination without recurrence of stenosis. NPT monitoring showed no significant difference in erectile function before and after operation. Conclusions For patients with posterior urethral stricture, the application of Urethra urethra anastomosis urethral anastomosis exact effect, to a certain extent, reduce the surgical factors for penile and urethral cavernous blood supply damage.