urethrotomy

Male urethral stricture is a common disease in urology, which can be divided into three categories according to its etiology, congenital, inflammatory and traumatic. Congenital urethral stricture is less common, such as congenital urethral stricture, urethral valve, fine hypertrophy, urethral lumen narrowing. Inflammatory urethral stricture is caused by a specific or non-specific urinary tract infection. In specific infections, gonorrhea urethral stricture is more common; in non-specific infections, the urethral orifice and penile urethral stricture are common due to repeated foreskin and penile head inflammation, and the inflammatory urethra is caused by improper placement of the catheter. Stenosis has attracted widespread attention. This type of stenosis is more common in the corpus cavernosum. The traumatic urethral stricture is the most common acquired urethral stricture. The stenosis depends on the injury site. Most of the causes are in the urethra of the ball. In patients with pelvic fractures, located in the urethra of the membrane or at the tip of the prostate, the stenosis is generally not long, but the scar is hard. Severe urethral stricture can cause upper urinary tract water and renal dysfunction. There is often inflammation in the proximal and surrounding tissues of the urethral stricture. In some cases, inflammation around the urethra, abscess around the urethra, and even scrotal perineum can be worn. The formation of long-term unhealed urethra fistula, often complicated by urinary tract and reproductive tract infections, and some cases also have a suprapubic bladder stoma, should be prepared according to the specific circumstances. Those with narrower stenosis and less scars are expected to be cured by urethral dilatation. If the urethral dilatation fails or the effect is not good, other surgical treatment methods should be chosen. Endoscopic surgery for the treatment of urethral stricture has a positive effect, has been widely used in clinical, with small trauma, less bleeding, less postoperative complications, etc., should be the preferred method for the treatment of urethral stricture. However, it requires special equipment. For complicated urethral strictures, especially those with long stenosis, open surgical treatment is still the main means. Therefore, endovascular treatment can not completely replace other surgical treatments. Treatment of diseases: urethral stricture Indication Urethral incision is suitable for congenital or acquired urethral stricture. Surgical procedure 1. External urethral opening After disinfection and anesthesia, a wing of an ophthalmic scissors is inserted into the outer urethral opening of the urethra, and the narrow urethral opening is longitudinally cut in the ventral side of the urethra to 0.5 to 1.0 cm of the normal urethra, so that the urethral opening of the urethra is cut. Consistent with the proximal urethral caliber, the urethral mucosa and the penile head epidermis were sutured in a "U" shape with a 4-0 gut or filament. 2. External urethral incision After disinfection anesthesia, use a slotted probe to insert into the narrow urethral orifice, and then use a sharp knife to follow the probe slot to cut the urethra from the urethral ventral side of the urethra to the urethra 0.5 to 1.0 cm, with 4-0 The absorbable thread or the thin thread intermittently sutures the wound edge between the urethral mucosa and the epidermis of the penis head.