内镜下使用改良自制尿道延长器行尿道肉阜电切术的初步体会

Initial experience with endoscopic urethral caruncle electrosurgery using a modified homemade urethral extender

摘要:

目的 探讨使用改良自制尿道延长器，对老年女性尿道肉阜患者行内镜下等离子电切术的临床效果。方法 2019年1月－2022年12月该院共收治尿道肉阜患者28例，均于改良自制尿道延长器辅助下行等离子电切术，分析患者手术时间、住院时间、导尿管留置时间和术后并发症发生等情况。结果 该组28例患者，均在自制尿道延长器辅助下顺利完成手术，无中转开放手术，手术时间15～40 min，平均（24.4±6.4）min；导尿管留置时间3～7 d，平均（5.1±1.1）d；住院时间4～8 d，平均（6.5±1.0）d；拔除导尿管后，均排尿通畅，无尿失禁和排尿困难等近期并发症发生，病理均提示尿道肉阜；随访时间2～22个月，平均（11.8±6.5）个月，无尿道狭窄和尿道肉阜复发等远期并发症发生。结论 内镜下使用改良自制尿道延长器治疗尿道肉阜，安全、有效。值得临床推广应用。

Abstract:

Objective To investigate the clinical results of plasma electrosurgery in elderly female patients with urethral caruncle using a modified homemade urethral extender.Methods 28 patients with urethral caruncle were admitted from January 2019 to December 2022, all with modified homemade urethral extender-assisted plasma electrosurgery, and the patients’ operative time, length of hospital stay, catheter retention time and occurrence of postoperative complications were analyzed.Results All the 28 patients in this group completed the operation successfully with the assistance of homemade urethral extender, no conversion to open surgery. The operation time was 15 ~ 40 min, with an average of (24.4 ± 6.4) min. The catheter retention time was 3 ~ 7 d, with an average of (5.1 ± 1.1) d. The hospitalization time was 4 ~ 8 d, with an average of (6.5 ± 1.0) d. After removal of catheter, all urination was clear, no recent complications such as urinary incontinence and urination difficulty, and all had pathology suggestive of urethral caruncle. Follow up time was 2 ~ 22 months, with an average of (11.8 ± 6.5) months, no long-term complications such as urethral stricture and recurrence of urethral caruncle occurred.Conclusion Endoscopic treatment of urethral caruncle with a modified homemade urethral extender is one of the safe and effective treatments that deserves clinical promotion.