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[内镜下尿道切开术治疗尿道狭窄的结果。附72例报告]

[Results of endoscopic urethrotomy in the treatment of urethral stricture. Apropos of 72 cases].

作者信息

Ballanger P, Midy D, Vely J F, Ballanger R

出版信息

J Urol (Paris). 1983;89(2):95-9.

PMID:6863972
Abstract

Seventy-two patients with strictures of the urethra were treated by endoscopic urethrotomy over a period of 2 years, the strictures being of iatrogenic origin in 37.5% and of undetermined etiology in 22% Important features of this series were the advanced age of the patients (57% between 60 and 80 years) and the iatrogenic nature of the lesion in many cases. Strictures were perineobulbar in 36 cases, of the anterior urethra in 13, multiple or extending in 6, and of the membranous urethra in 17 cases. Retromeatal and cervical strictures were not included. Urethrotomy (at 12 o'clock) was followed by insertion of a urethral catheter retained for 5 days. Complications included one case of severe infection and 2 cases of epididymo-orchitis. Follow-up has been for from 6 to 36 months. Good results were obtained in 41 cases (57%), with absence of dysuria and lack of the need for dilatation. Results were moderate in 9 cases (12.5%), with functional improvement but altered flow and the need for less than 2 dilatations per year. Treatment was a failure in 23 cases (32%), the condition remaining unaltered and requiring either multiple dilatations or a repeat urethrotomy. Overall therapeutic efficacy was 70%, the poorest results being observed in extensive or membranous urethra strictures.

摘要

在两年的时间里,72例尿道狭窄患者接受了内镜下尿道切开术治疗,其中37.5%的狭窄为医源性,22%病因不明。该系列的重要特征是患者年龄较大(57%在60至80岁之间),且许多病例中病变具有医源性。36例狭窄位于会阴球部,13例位于前尿道,6例为多发或累及多处,17例位于膜部尿道。未包括后尿道和颈部狭窄。尿道切开术(在12点处)后插入尿道导管并保留5天。并发症包括1例严重感染和2例附睾睾丸炎。随访时间为6至36个月。41例(57%)取得了良好效果,无排尿困难且无需扩张。9例(12.5%)效果中等,功能有所改善,但尿流改变且每年需要少于2次扩张。23例(32%)治疗失败,病情无变化,需要多次扩张或再次进行尿道切开术。总体治疗有效率为70%,在广泛或膜部尿道狭窄中观察到的结果最差。

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