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目的:探讨输尿管镜下尿道置管术治疗早期后尿道断裂的临床疗效。方法:回顾性分析22例骨盆骨折伴后尿道断裂患者,早期行耻骨上膀胱造瘘,伤后3～5天行输尿管镜下尿道置管会师术,术后留置尿管4周,通过随访3、6、12个月,评估其长期效果。结果:本组22例患者置管均成功,手术时间20±7.5分钟,出血2～20ml,随访3个月～12个月,其中18例正常排尿,最大尿流率15.6±2.4ml/s(12～18ml/s),尿道狭窄4例,通过尿道扩张治愈,勃起功能障碍1例。结论:在骨盆骨折合并后尿道断裂的早期治疗中,输尿管镜引导下尿道会师牵引术是一种微刨、简单、安全、有效的方法。
Objective: To investigate the clinical efficacy of ureteroscopic urethral catheterization in the treatment of early posterior urethral rupture. Methods: Twenty-two cases of pelvic fracture with posterior urethral rupture were retrospectively analyzed. The suprapubic cystostomy was performed in the early stage. Ureteroscopic urethral catheterization was performed 3 to 5 days after injury. The catheter was placed for 4 weeks after operation. , 6,12 months to assess its long-term results. Results: Twenty-two patients in this group were successfully managed. The operation time was 20 ± 7.5 minutes and the bleeding was 2 ~ 20ml. The follow-up ranged from 3 months to 12 months. Among them, 18 cases had normal urination and the maximum uroflow rate was 15.6 ± 2.4ml / s 12 ~ 18ml / s), urethral stricture in 4 cases, cured by urethral dilatation, erectile dysfunction in 1 case. Conclusions: Ureteroscopic guided urethral instrumentation is an easy, safe, and effective method for the early treatment of pelvic fractures complicated with posterior urethral rupture.