METHOD FOR SURGICAL TREATMENT OF POSTERIOR URETERAL OBLITERATIONS

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, particularly to urology. Method involves endoscopic recanalization of the posterior urethra with introducing into the urethra a suspension of a fragmented autograft of buccal mucosa and a fibrin-thrombin glue. Area of the buccal mucosa Sb taken up is 1/6 of the surface area of the wound surface in the urethra after recanalization of Su; the area Su is calculated by formula: Su=πl, where l is length of obliteration in cm, determined radiologically +1 cm, area Sb is rounded to tenth of obtained value. Produced flap of buccal mucosa is washed in a solution of antibiotics with volume of 2 ml. Flap is fragmented to particles sized to 1 mm; the graft fragments in the antibiotic solution are subjected to centrifugation in mode of 1,700 rpm for 5 minutes. Obtained precipitate is resuspended in 1 ml of said antibiotic solution and divided into 2 parts, each of which is mixed with one of two components of fibrin-thrombin glue, equal in volume, wherein total volume of glue is calculated by formula: V=0.18πl, where l is length of obliteration in cm, determined radiologically +1 cm, performing endoscopic recanalization of posterior urethra, installing urethral catheter with diameter of 16 Ch, parallel to urethral catheter to incision is a two-way ureteral catheter, through which two components of glue with a suspension of buccal mucosa fragments are simultaneously introduced by two syringes, the urethral catheter is removed 28 days after the operation.;EFFECT: method provides higher effectiveness and reduced intraoperative injuries ensured by minimally invasive intervention and formation of a whole, seam-free fragment of neo-urethra in postoperative recovery.;1 cl, 3 dwg, 1 ex