Healy C E, Leonard D S, Cahill R, Mulvin D, Quinlan D
St Vincent's University Hospital, Elm Park, Dublin 4.
Ir Med J. 2007 Jun;100(6):488-9.
The management of posterior urethral disruption is controversial. Debate continues on whether primary realignment at results in a higher incidence of incontinence and impotence compared to delayed reconstruction. We report on our experience using early endoscopic realignment. Between 1994 and 2002 ten male patients, diagnosed with complete posterior urethral disruption, had attempted early endoscopic realignment. All patients were evaluated for incontinence, impotence and stricture formation post-operatively. Six patients had endoscopic retrograde realignment, two proceeded to endoscopic rendezvous realignment and two patients had delayed reconstruction of the urethra. At follow-up, mean 41.4 months, all patients were continent four were impotent and four patients developed strictures. Endoscopic retrograde realignment is a simple atraumatic technique for early posterior urethra realignment. If unsuccessful a rendezvous approach can be attempted at the same operation. Manipulation of the periprostatic issue is minimal thus preventing iatrogenic complications.
后尿道断裂的处理存在争议。与延迟重建相比，一期复位是否会导致更高的尿失禁和阳痿发生率，目前仍存在争论。我们报告了我们使用早期内镜复位的经验。1994年至2002年间，10例被诊断为完全性后尿道断裂的男性患者尝试了早期内镜复位。所有患者术后均接受了尿失禁、阳痿和尿道狭窄形成的评估。6例患者接受了内镜逆行复位，2例进行了内镜会师复位，2例患者进行了延迟尿道重建。随访时，平均41.4个月，所有患者均能控制排尿，4例阳痿，4例患者出现尿道狭窄。内镜逆行复位是一种简单的无创技术，用于早期后尿道复位。如果不成功，可以在同一次手术中尝试会师方法。对前列腺周围组织的操作极少，从而防止了医源性并发症。
