Takeuchi T, Ishihara S, Nagatani Y, Koide T, Sakai S, Tamaki M, Maeda S, Yamamoto N, Kobayashi S, Kawada Y
Department of Urology, Gifu Prefectural Hospital.
Nihon Hinyokika Gakkai Zasshi. 1991 May;82(5):750-7. doi: 10.5980/jpnjurol1989.82.750.
We performed transluminal re-canalization by needle puncture under fluoro-endoscopic control on a total of ten patients (membranous urethra, 8; bulbous urethra, 2) with complete obliteration after traumatic urethral disruption. The re-canalized tract was created by balloon dilation, internal urethrotomy or endoscopic resection of the scar tissue. The patient age ranged from 10 to 57 years (mean age; 37.9 +/- 15.3 years). A transluminal puncture was attempted in three patients by transperineal-transurethral approach and in seven by transurethral approach. In one of them, who sustained a complete membranous disruption 5 weeks ago, transluminal puncture failed because of the movable proximal urethra. The remaining nine patients voided without difficulty for the mean follow-up period of 18.1 +/- 14.3 months (range: 2-46). Three patients had mild stress urinary incontinence. A transluminal puncture is less invasive, safe and reliable for re-establishment of the true proximal part of the disrupted urethra. It can be recommended as a useful technique for endo-urological re-establishment for a completely obliterated urethra. Although this endoscopic re-establishment requires urethral sounding or internal urethrotomy for 6 months postoperatively, it may be an alternative to conventional surgical repair.
我们在荧光内镜控制下通过针穿刺对总共10例创伤性尿道断裂后完全闭塞的患者（膜部尿道8例；球部尿道2例）进行了经腔再通术。通过球囊扩张、尿道内切开术或内镜下切除瘢痕组织来创建再通通道。患者年龄在10至57岁之间（平均年龄；37.9 +/- 15.3岁）。3例患者尝试经会阴-经尿道途径进行经腔穿刺，7例采用经尿道途径。其中1例患者在5周前发生了完全性膜部断裂，由于近端尿道可移动，经腔穿刺失败。其余9例患者在平均18.1 +/- 14.3个月（范围：2 - 46个月）的随访期内排尿无困难。3例患者有轻度压力性尿失禁。经腔穿刺对于重建断裂尿道的真正近端部分侵入性较小、安全且可靠。它可被推荐为一种用于完全闭塞尿道的腔内泌尿外科重建的有用技术。尽管这种内镜重建术后需要进行尿道探子探查或尿道内切开术6个月，但它可能是传统手术修复的一种替代方法。
