CAJ | 학술논문

目的：探讨膀胱穿刺输尿管软镜下尿道会师术治疗尿道断裂的临床方法和效果。方法17例尿道断裂患者,应用膀胱穿刺造瘘输尿管软镜下尿道会师术治疗,分析治疗效果。结果17例手术全部成功,11例患者排尿顺畅,6例有尿道狭窄存在,其中5例定期行尿道扩张而好转,1例扩张后效果不佳,3个月后行等离子镜尿道狭窄切开术,术后排尿良好,无术后明显出血、感染、尿瘘、尿失禁,1例有轻度的勃起功能障碍。结论膀胱造瘘输尿管软镜下尿道会师术在可视下进行,避免了传统开放手术的盲目性和医源性损伤,降低了手术风险,适合于早期尿道断裂的治疗。
목적：탐토방광천자수뇨관연경하뇨도회사술치료뇨도단렬적림상방법화효과。방법17례뇨도단렬환자,응용방광천자조루수뇨관연경하뇨도회사술치료,분석치료효과。결과17례수술전부성공,11례환자배뇨순창,6례유뇨도협착존재,기중5례정기행뇨도확장이호전,1례확장후효과불가,3개월후행등리자경뇨도협착절개술,술후배뇨량호,무술후명현출혈、감염、뇨루、뇨실금,1례유경도적발기공능장애。결론방광조루수뇨관연경하뇨도회사술재가시하진행,피면료전통개방수술적맹목성화의원성손상,강저료수술풍험,괄합우조기뇨도단렬적치료。
Objective To investigate clinical method and effect of bladder puncture flexible ureteroscopic urethral realignment in the treatment of urethral disruption. Methods A total of 17 patients with urethral disruption received treatment by bladder puncture colostomy flexible ureteroscopic urethral realignment. Their curative effects were analyzed. Results All the 17 cases received successful operation, and 11 cases of them had fluent urination, the other 6 cases had urethrostenosis. Among them, there were 5 improved cases under regular urethral dilatation, and 1 case with poor effect of dilatation. Plasma internal urethrotomy after 3 months provided good postoperative urination, without obvious hemorrhage, infection, urinary fistula, and uracratia. There was 1 case with mild erectile dysfunction. Conclusion Implement of bladder puncture colostomy flexible ureteroscopic urethral realignment under visible condition can avoid blindness and iatrogenic injury of traditional open surgery. This method can reduce surgical risk, and it is suitable for treating early urethral disruption.