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目的探讨男性尿道损伤或(和)狭窄的临床治疗效果。方法选择我院2007年5月至2009年5月尿道损伤或(和)狭窄的患者124例。骨盆骨折后尿道损伤给予单纯留置导尿管、尿道会师术、尿道端端吻合术。尿道狭窄患者给予经尿道内窥镜直视下狭窄切开术(DVIU)、行尿道吻合术、带蒂皮瓣或移植物技术尿道替代成形术、尿道外口成形术。结果本组患者随访平均18月。①行DVIU84例,67例(79.7%)手术成功,17例患者手术失败;②内窥镜直视下狭窄切开术17例,手术成功15例(88.2%),失败2例,为既往有过尿道手术失败或DVIU术失败者;③行替代尿道成形术共19例,运用游离膀胱黏膜替代术5例、阴茎皮肤(包括包皮)替代术7例,带蒂阴茎阴囊皮瓣修复7例。结论 DVIU是尿道狭窄(<2cm)的首选方法。吻合式尿道成形术在尿道狭窄治疗中具有较高成功率,相关并发症较少。替代式尿道成形术是治疗复杂性尿道狭窄的重要方法,但并发症较多。
Objective To investigate the clinical effect of male urethral injury or (or) stenosis. Methods 124 patients with urethral injury or (or) stenosis in our hospital from May 2007 to May 2009 were selected. Urinary tract injury after pelvic fracture given a simple indwelling catheter, urethra will be orthopedic, urethral anastomosis. Urethral stricture patients undergoing transurethral resection of the urethral stricture (DVIU), urethral anastomosis, pedicle flap or graft urethroplasty, urethral plasty. Results The patients were followed up for an average of 18 months. (1) 61 patients (79.7%) underwent DVIU successfully and 17 patients underwent unsuccessful operation. (2) Seventeen patients underwent endoscopic stenosis, 15 (88.2%) had successful operation and 2 failed Over urethral surgery failed or DVIU failed; ③There were 19 cases of urethroplasty replacement, 5 cases of free bladder mucosal replacement, 7 cases of penile skin (including foreskin) replacement, and 7 cases of pedicled penis scrotum flap. Conclusion DVIU is the preferred method of urethral stricture (<2cm). Anastomosis urethroplasty in the treatment of urethral stricture with a high success rate, fewer complications. Alternative urethroplasty is an important method for the treatment of complex urethral strictures, but there are more complications.