论文部分内容阅读
目的:探索医源性尿道狭窄的诊断及治疗现状。方法:回顾性收集2012年1月~2015年2月单个尿道诊治中心收治的316例男性尿道狭窄患者的资料,包括年龄、原发病因、狭窄部位、狭窄长度、复发率及相应治疗方式。原发病因分为尿道下裂修复失败,导尿,尿道器械损伤,经尿道灌注化疗及其他,分析医源性尿道狭窄病因与狭窄部位、长度、治疗方式及手术成功率之间关系。结果:尿道器械损伤是医源性尿道狭窄最常见病因(176例,占55.69%),其次为导尿(82例,占25.95%)、经尿道灌注化疗(18例,占5.70%)、尿道下裂修复失败(14例,占4.43%),其他有26例(8.23%)。前尿道狭窄共212例(67.09%),后尿道60例(18.98%),多部位尿道44例(13.93%);平均狭窄长度为(3.4±2.32)cm,经尿道灌注化疗可导致长段尿道狭窄,平均狭窄长度达到(5.8±3.52)cm。尿道成形术是治疗医源性尿道狭窄最常用术式,占58.23%(184/316)。总体成功率84.50%(229/271),其中经尿道化疗灌注术后再狭窄率较其他病因类型明显更高。结论:我们的单中心研究表明尿道器械损伤是最常见的医源性尿道狭窄病因,且多数医源性尿道狭窄发生于前尿道。同时,医源性损伤类型与狭窄部位和长度均密切相关,不仅影响医源性尿道狭窄在治疗方式的选择,同时也关系到其预后情况。
Objective: To explore the diagnosis and treatment of iatrogenic urethral stenosis. Methods: The data of 316 patients with urethral stricture admitted from a single urethral diagnosis and treatment center from January 2012 to February 2015 were retrospectively collected. The data included age, primary etiology, location of stenosis, length of stenosis, relapse rate and corresponding treatment. The primary cause was divided into failed hypospadias repair, catheterization, urethral device injury, transurethral chemotherapy and others. The relationship between iatrogenic urethral stricture and stenosis, length, treatment and operation success rate was analyzed. Results: The urethral device injury was the most common cause of iatrogenic urethral stenosis (176 cases, accounting for 55.69%), followed by catheterization (82 cases, accounting for 25.95%), transurethral chemotherapy (18 cases, 5.70% Failure of repair of the inferior septum (14 cases, 4.43%), the other 26 cases (8.23%). There were 212 cases (67.09%) of the anterior urethral stricture, 60 cases (18.98%) of the posterior urethra and 44 cases (13.93%) of the multi-part urethra. The mean length of stenosis was (3.4 ± 2.32) cm. Transurethral chemotherapy could lead to long urethra Stenosis, the average length of stenosis (5.8 ± 3.52) cm. Urethroplasty is the most commonly used surgical treatment of iatrogenic urethral stricture, accounting for 58.23% (184/316). The overall success rate was 84.50% (229/271). The rate of restenosis after transurethral chemotherapy was significantly higher than that of other causes. CONCLUSIONS: Our single center study shows that urethral device injury is the most common cause of iatrogenic urethral stricture and most iatrogenic urethral strictures occur in the anterior urethra. At the same time, the type of iatrogenic injury is closely related to the site and length of stenosis, which not only affects the selection of iatrogenic urethral stricture but also the prognosis.