目的:评估膀胱软镜联合尿道内切开镜会师治疗骨盆骨折术后尿道狭窄的临床疗效。方法:采用膀胱软镜联合尿道内切开镜会师治疗骨盆骨折术后尿道狭窄男性患者12例,中位年龄33(19～54)岁。术前行尿道探子会师+尿道造影对狭窄部位和长度进行评估,经造瘘口置入膀胱软镜探及尿道内口,经尿道外口置入尿道内切开镜并调暗光源,在膀胱软镜光源引导下行尿道狭窄内切开术,并对手术时间、失血量、并发症进行记录。术后留置尿管1个月,拔除尿管后每月进行随访,术后3个月行尿道造影、尿流率及国际勃起功能指数问卷(IIEF)评分评估。结果:手术均获成功,手术时间(37±12)min,手术后血红蛋白较术前降低(4.5±2.3)g/L,拔除尿管后无尿失禁,术前术后IIEF评分无明显变化(12.4±6.6vs 13.1±7.0,P>0.05)。随访6～22个月,9例无需进一步处理,排尿正常;3例拔除尿管后出现排尿困难和继发性尿道狭窄,给予每周1次尿道扩张,2例连续4周、1例连续6周尿扩后可置入F18尿道探子,排尿正常,术后3个月Qmax均在(16.2±5.8)ml/s以上。结论:膀胱软镜联合尿道内切开镜会师治疗骨盆骨折术后尿道狭窄简便易行,创伤小,并发症少,近期及远期疗效满意,可作为骨盆骨折术后尿道狭窄的首选治疗方法。 OBJECTIVE: To evaluate the clinical efficacy of bladder and endoscopic urethrotomy in the treatment of urethral stricture after pelvic fracture. Methods: Twelve patients with urethral stricture were treated with bladder soft-lens combined with endoscopic urethral debridement. The median age was 33 (19-54) years. Preoperative urethral probe masters + urethrography to assess the location and length of the stenosis, the stoma was placed into the bladder soft mirror exploration and urethral mouth, the urethral incision through the urethral opening mirror and darken the light source in the bladder Soft mirror light source guided urethral stricture incision, and the operation time, blood loss, complications were recorded. Postoperative urethral catheterization was performed for 1 month, followed by monthly follow-up after catheter removal. Urethral angiography, urinary flow rate, and IIEF scores were assessed 3 months after surgery. Results: The operation was successful. The operation time was 37 ± 12 min. The postoperative hemoglobin was decreased by (4.5 ± 2.3) g / L compared with that before operation. Urinary incontinence was not associated with urinary incontinence. There was no significant difference in preoperative and postoperative IIEF scores 12.4 ± 6.6 vs 13.1 ± 7.0, P> 0.05). All the patients were followed up for 6 to 22 months. Nine patients were normal without urination and urination was normal. Three patients had dysuria and secondary urethral stricture after removal of the catheter. Urethral dilatation was given once a week for 2 consecutive weeks and 1 for 6 consecutive months Weekly urinary expansion can be placed F18 urethral probe, normal urination, 3 months after Qmax (16.2 ± 5.8) ml / s or more. Conclusions: Bladder soft-lens combined with intraurethral resection of the urethra is an easy and convenient procedure for the treatment of urethral stricture after pelvic fracture. It has less trauma and less complications, and has satisfactory short-term and long-term curative effect. It can be used as the first choice for treatment of urethral stricture after pelvic fracture.