Urethral stricture repair

Urethral stenosis repair is suitable for urethral membrane or prostate stenosis and transurethral expansion failure. Drainage and suturing the bladder and abdominal wall, and inserting a fistula catheter into the bladder from the incision of the bladder. The urethral catheter and the bladder fistula are connected with a silk thread and placed in the bladder. The bladder wall was sutured intermittently with a 2-0 gut. After the cigarette was drained in the posterior pubic space, the abdominal wall incision was sutured layer by layer. Treatment of diseases: urethral stricture Indication The urethral membrane or prostate stenosis fails through the urethra. Contraindications Combined with other organ diseases, such as severe cardiovascular disease, respiratory disease, hemorrhagic disease, etc., can not tolerate anesthesia. Preoperative preparation 1. Correct the shock before surgery. 2. Preoperative urinary retention with acute urinary retention, in order to prevent urinary extravasation and reduce the patient's pain, bladder puncture can be performed first, and urine can be withdrawn. Surgical procedure 1. Position: The position of the stone. 2. Incision, exposure and cutting of the urethral stricture: for the perineal arc or human incision. Cut the corpus cavernosum muscle along the midline and separate it from the sides, cut the penis fascia, and separate the corpus cavernosum. A metal urethral probe is inserted from the urethra to the distal end of the urethral stricture. The stenosis is mostly at the proximal end of the urethral bulb or on the surface of the triangular ligament. The urethra is cut at the tip of the urethral probe and the corpus cavernosum is separated to the vicinity of the penile suspensory ligament. 3. Find and cut the urethral stricture through the bladder: the pubis is incision of the bladder, and the metal urethral probe is inserted into the bladder, and the bladder neck is placed at the proximal end of the urethral stricture. When the probe is pushed down, the tip of the probe can be felt on the perineal triangular ligament. The scar tissue is cut at the tip to expose the probe. 4. Excision of scar tissue: The triangular ligament is cut around the transurethral urethral probe, and the scar tissue is cut into small pieces with a sharp knife until the prostate tip is fully exposed and can be freely passed through the thick metal probe. When separating the trailing edge, care should be taken not to damage the anterior wall of the rectum; if you are not sure, you can use the left hand to extend into the anus to assist in the operation. When the finger is pulled out after the operation is completed, the glove should be replaced. 5. Anastomosis of the urethra: The 20 to 22 catheter is directly from the urethra manuscript to the bladder. The urethral bulb was sutured to the tip of the prostate with a 2-0 chrome gut. The suture begins with the posterior wall, does not pass through the mucosa, the knot is struck outside, and the anterior wall is finally sutured. 6. Suture the perineal incision: suture the bulbous muscle in the median line, drain the skin with the wound, and suture the perineal incision with silk. 7. Drainage and suture of the bladder and abdominal wall: a fistula-shaped catheter is made from the incision of the bladder, and the urethral catheter and the bladder fistula are connected by a silk thread and placed in the bladder. The bladder wall was sutured intermittently with a 2-0 gut. After the cigarette was drained in the posterior pubic space, the abdominal wall incision was sutured layer by layer. complication Urinary tract infection.