Clinical Observation On Male Posterior Urethral Stricture Or Atresia Treatment By Endoscopic Urethrotomy

Objective To evaluate the efficacy and safety of endoscopic urethrotomy and the traditional open surgery for the male posterior urethral stricture or atresia.Methods A total of42patients who were diagnosed with male posterior urethral stricture or atresia from February2011to December2012in Qinghai Provincial People’s Hospital, and were divided into two groups,20patients were taken combination endoscopic urethrotomy (the group of combination endoscopic urethrotomy),22patients were treated with traditional open surgery(the group of traditional open surgery). By analyzing the clinical data, the group of combination endoscopic urethrotomy and the group of traditional open surgery, the operation time, the blood loss and the day in hospital were compared; and all patients with followed up (6to16month, an average12months), comparing the postoperative urethra dilation times, Qmax, PVR, the cure rate and secondary complications. Comparing two sets of all the data by statistical analysis, to compare the clinical efficacy of two groups.Results1. The group of combination endoscopic urethrotomy and the group of traditional open surgery treatment of posterior urethral stricture and atresia, the operation time were (46.1±6.5) min and (148.3±8.6) min, the blood loss were (26±3.7) ml and (226.5±12.6) ml. The differences between combination group of endoscopic urethrotomy and the group of traditional open surgery operation with operation time and blood loss were significant (P<0.05), and the group of combination endoscopic urethrotomy was significantly better than the group of traditional open surgery.2. The group of combination endoscopic urethrotomy and the group of traditional open surgery treatment of posterior urethral stricture and atresia, the day in hospital were (16.3±5.5) d and (26.8±6.9) d. The differences between combination group of endoscopic urethrotomy and the group of traditional open surgery with the day in hospital were significant (P<0.05).3. All patients were followed up for6to16months after operations, an average of12months. The group of combination endoscopic urethrotomy and the group of traditional open surgery operation, the number of time for urethra dilation were (13.6±2.1) and (14.1±1.6), the Qmax were (21.3±1.2) ml/s and (19.8±1.9) ml/s, the PVR were (6.2±1.5) ml and (7.6±1.2) ml. Between the two groups with the number of time for urethra dilation, Qmax and PVR showed no significant differences (P>0.05).4. After conventional urethra dilation,2months without urethra dilation to be heal standards. In the20cases of combination endoscopic urethrotomy therapy group,19cases were cured and the cure rate is95.00%. In the22traditional open surgery group,21cases were cured, the cure rate is95.45%. Cure rates between the group of combination endoscopic urethrotomy and the group of traditional open surgery were no significant difference (P>0.05).Conclusions1. Endoscopic urethrotomy with traditional open surgery in the treatment of simple posterior urethral stricture or atresia have similar cure rates.2. The treatment of male posterior urethral stricture or atresia with endoscopic urethrotomy have the advantages of simple operation, safety, less complication, faster postoperative recovery and low recurrence rate, and can be used as the first choice of the treatment for simplex posterior urethral stricture or atresia.3. The keys of treatment male posterior urethral stricture or atresia are to choose different surgical methods according to the different of urethrostenosis.4. The postoperative urethral regularly can effectively prevent the recurrence of urethral stricture.