输尿管镜下行尿道会师术治疗尿道断裂42例报告

摘要

ObjectiveTo investigate the treatment of urethral realignment ureteroscopy downstream clinical effects urethral rupture.MethodsFrom January 2010 to November 2012 the hospital admitted 42 patients with urethral rupture. The postoperative diagnosis of urethral rupture in 22 cases, 20 cases of posterior urethral rupture, and the patient had no bladder rupture, no abdominal visceral injury. Only one case of patients with varying degrees of shock performance, 6 patients with lower limb fractures.ResultsOf the 42 patients had successful surgery. After four weeks after surgery, 36 patients extubated urination; six patients patients after 1~6 months of conventional urethral dilation, urination is normal, no urinary ifstula and incontinence patients. 8 weeks after surgery, the patient's urine lfow rate detection, 37 patients maximum lfow rate of greater than 16 ml/s, and the remaining 5 patients, the maximum lfow rate of 10~16 ml/s. 3~12 months of follow-up were normal urination, no residual urine and erectile dysfunction.ConclusionUrethral realignment urethral rupture advantages:①Surgical procedure is relatively simple, safe , satisfactory results;②Erectile dysfunction and urethral stricture fewer complications;③Faster recovery, shorter hospital stay;④Erectile nerves and blood vessels can be oppressed rapidly reduced. It can be seen ureteroscopy downstream urethral realignment is the preferred method of treatment of urethral rupture, worthy of promotion.%目的：探讨输尿管镜下行尿道会师术治疗尿道断裂的临床效果。方法选取2010年1月至2012年11月本院收治的尿道断裂患者42例。术后诊断前尿道断裂患者22例，后尿道断裂患者20例，且患者均无膀胱破裂、无腹腔内脏损伤。仅有1例患者合并出现不同程度的休克，6例患者伴有下肢骨折。结果42例患者均手术成功。术后4周拔管后36例患者排尿通畅，6例患者经1～6个月常规行尿道扩张术，排尿正常，无尿瘘及尿失禁患者。术后8周检测患者的尿流率，37例患者最大尿流率＞16 ml/s，其余5例患者的最大尿流率为10～16 ml/s。随访3～12个月均排尿正常，无残余尿及勃起功能障碍。结论应用尿道会师术治疗尿道断裂优点：①手术操作相对简单、安全、效果满意；②勃起功能障碍及尿道狭窄等并发症少；③恢复快、住院时间短；④阴茎勃起神经与血管收缩压迫可迅速减轻。由此可见，输尿管镜下行尿道会师术治疗尿道断裂为首选方法，值得临床推广。