经尿道钬激光治疗男性尿道狭窄

目的:探讨经尿道钬激光治疗男性尿道狭窄的方法、安全性和疗效。方法:对38例男性尿道狭窄患者行经尿道狭窄段疤痕钬激光切除(功率10~45W),狭窄段长度:<1.0cm者18例,1.0~1.5cm者9例,>1.5cm者7例,完全闭锁者4例,并发膀胱结石者6例。平均最大尿流率为(5.6±2.3)ml/s。结果:36例手术成功,无大出血、尿外渗、直肠损伤等并发症发生,术后平均最大尿流率为(17.5±3.4)ml/s,2例中转开放手术,32例获随访3~18个月,其中4例行定期尿道扩张,2例以钬激光行二次手术后治愈。结论:经尿道钬激光治疗男性尿道狭窄安全、有效、创伤小、可重复治疗。

Holmium Laser Urethrotomy for Male Urethral Stricture

OBJECTIVE: To evaluate transurethral holmium laser incision, its safety and effect in the treatment of male urethral stricture. METHODS: Thirty-eight males with urethral stricture were treated by 1045 W holmium laser urethrotomy, 18 with the stricture length shorter than 1.0 cm, 9 between 1.0 cm and 1.5 cm, 7 longer than 1.5 cm , 4 with occlusive stricture and 6 companies with bladder calculus. The average peak urinary flow rate (Q(max)) was (5.6 +/- 2.3) ml/s. RESULTS: Successful surgery was achieved in 36 of the cases, with no complications and the average Q(max) increased to (17.5 +/- 3.4) ml/s. Two cases were converted to open surgery. Thirty-two cases were followed up for 3-18 months, of whom 4 received urethral dilation and 2 underwent a second holmium laser urethrotomy. CONCLUSION: Holmium laser urethrotomy is a safe, effective and minimally invasive therapeutic modality for male urethral stricture.