Cohen J K, Miller R J, Shuman B A
Allegheny General Hospital, Medical College of Pennsylvania, Pittsburgh, USA.
Urology. 1995 May;45(5):861-4. doi: 10.1016/S0090-4295(99)80095-8.
Cryoablation of the prostate has been shown to be a useful tool in the eradication of prostate cancer. Sloughing of necrotic tissue per urethra was one of the major complications of prostate cryosurgery during its initial application and led to its disuse by urologists. A catheter was then needed until sloughing was complete and the patient again able to void. In a previous report, we have demonstrated that thermal protection of the urethra could be obtained by flowing warm irrigant through a thin-walled urethral conduit. To simplify the application of this heat, a dual lumen urethral catheter has been designed that can be passed transurethrally to circulate warm saline and prevent the destruction of the urethral epithelium. This prevents transmural necrosis, maintaining the epithelial barrier for containment of necrotic prostate tissue after treatment. This urethral warming device is made of materials commonly found in operative stockrooms. To date, the device has functioned well with a urethral sloughing rate of 12% during its initial use.
前列腺冷冻消融已被证明是根除前列腺癌的一种有用工具。尿道坏死组织脱落是前列腺冷冻手术最初应用时的主要并发症之一，导致泌尿外科医生不再使用该方法。在此期间需要留置导管，直到坏死组织脱落完成，患者再次能够排尿。在之前的一份报告中，我们已经证明，通过薄壁尿道导管流动温热冲洗液可以实现对尿道的热保护。为了简化这种加热的应用，设计了一种双腔尿道导管，可经尿道插入以循环温热盐水并防止尿道上皮破坏。这可防止透壁坏死，在治疗后维持上皮屏障以容纳坏死的前列腺组织。这种尿道加温装置由手术室仓库中常见的材料制成。迄今为止，该装置运行良好，初次使用时尿道脱落率为12%。
