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目的:探讨小儿尿道外伤及外伤后尿道狭窄的诊治经验。方法:8例新鲜后尿道断裂中,3例行经耻骨上与会阴入 路的尿道修复术、尿道会师及膀胱造瘘各2例,1例女童行经耻骨后尿道吻合术。陈旧性后尿道外伤患儿18例,其中经尿道内 切开(TUR)10例,经耻、会阴联合修复尿道及经会阴修复尿道各4例,经直肠会阴修复尿道1例。结果:8例新鲜后尿道断裂的患 儿术后出现尿道狭窄5例、不全尿失禁1例。陈旧性尿道狭窄行经尿道内切开术(TUR)的成功率为60.0％,经会阴及经耻、会 阴联合入路永道修复术的成功率为91.7％,有不全尿失禁5例,会阴尿道造瘘尚未修复1例。结论:后尿道外伤的急症处理非常 重要,如患儿情况允许应尽量行经耻、会阴联合尿道修复手术。经尿道内切开适用于绝大多数单纯性后尿道狭窄,经耻、会阴联合 或经会阴修复尿道适用于复杂性后尿道狭窄或TUR失败者。
Objective: To investigate the diagnosis and treatment of pediatric urethral trauma and traumatic urethral stricture. Methods: Among 8 cases of fresh posterior urethral rupture, 3 cases underwent urethroplasty, urethra division and cystostomy in 2 cases and 1 case underwent retropubic urethral anastomosis in 3 cases. 18 cases of old traumatic urethral trauma, including 10 cases of transurethral incision (TUR), shame and perineum combined repair of the urethra and perineal repair of the urethra in 4 cases, rectal perineal repair of the urethra in 1 case. Results: Eight cases of fresh urethral rupture occurred in 5 cases of urethral stricture and incomplete urinary incontinence in 1 case. The success rate of transurethral incision (TUR) in old urethral stricture was 60.0%. The success rate of transurethral and shame combined perineal repair was 91.7%, with incomplete urinary incontinence in 5 cases, urethral urethra Fistula has not been repaired in 1 case. Conclusion: Emergency treatment of posterior urethral trauma is very important, such as children should be allowed to undergo shame, perineal urethral repair surgery. Transurethral incision for the vast majority of simple posterior urethral stricture, shame, perineum or perineal urethral repair for complex posterior urethral stricture or TUR failure.