Transperineal urethrotomy

Urethral calculi are rare compared with other parts of the urinary tract stones, divided into primary and secondary. Primary urethral calculi are rarer than secondary urethral calculi, and more often occur on the basis of existing lesions in the urethra, such as urethral stricture, diverticulum, and foreign bodies. After the formation of stones, it can increase the damage of the urethra. Most of the secondary urethral stones are discharged from the upper urinary tract stones or bladder stones and embedded in the urethra, and may even come from prostate stones. Secondary urethral stones can also cause local tingling, urinary obstruction and infection, and even secondary urethral stricture, urethral fistula and upper urinary tract damage. Male urethral stones are most likely to stay in the urethral lumen and the small part of the lumen, so it is more common in the urethra of the prostate, the urethra of the ball, the urethra at the junction of the penis and scrotum, and the scaphoid. Smaller urethral stones can generally be taken by oral administration of Chinese herbal medicine or by transfusion of liquid paraffin through the urethra, which is facilitated by urination, or by urethroscopic forceps and gravel. Some posterior urethra stones can be pushed into the bladder with metal probes and treated with gravel. If the urethral calculi are too large, or if the above treatment fails to be discharged, surgery should be used promptly. According to the location of the urethra stones, different surgical approaches, scaphoid stones, can be removed by cutting through the external urethra. For primary urethral stones, the primary disease of the urethra that causes the stones should be treated together. Treatment of diseases: urethra stones Indication Perineal urethrotomy is suitable for urethral stones located before the urethra of the membrane and at the junction of the penis and scrotum. It has been incarcerated or failed to be removed by other means, or the stone is located in the chamber or there is a stone in front of the stone. Those with narrow urethra. Preoperative preparation Stone incarceration causes urethral inflammatory secretions, anti-infective treatment should be strengthened before surgery. Surgical procedure 1. The incision of the perineal median longitudinal incision, from the root of the scrotum, about 3cm long, layer by layer to cut the skin, subcutaneous tissue and deep fascia of the perineum, showing the corpus cavernosum. 2. Cut the corpus cavernosum muscle, reveal the ball urethra and cut the corpus cavernosum muscle longitudinally, revealing and freeing the ball urethra. At this time, the stones in the urethra can generally be touched. 3. Cut the urethra, remove the stones and reveal the urethra, cut the urethra longitudinally at the stone, and remove the stones. If the stone is in front, it can be cut through the urethra and taken out by a stone pliers. 4. After suturing the urethra and bulbar muscles, the urethral stricture or diverticulum should be checked. Those with this lesion should be removed or repaired at the same time. After urethral surgery, the F16 catheter was placed in the urethra, the urethral incision was sutured with a 2-0 absorbable line, and the corpus cavernosum was sutured with a thin wire. 5. Place the drainage, close the incision, rinse the incision with isotonic saline, place a rubber strip in the incision, and suture the fascia, subcutaneous tissue and skin incision layer by layer.

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