외상성 후부요도 완전협착에서 내요도절개술의 10년 경험
The Years Experience of Post-Traumatic Complete Urethral Stricture Treated with Endoscopic Internal Urethrotomy
변재상, 송재만,
소속 상세정보
변재상 ( )
연세대학교
송재만 ( )
연세대학교 의과대학 원주기독병원
KMID : 0358319960370111300
Abstract
We reviewed our experience retrospectively with 65 patients who had post-traumatic complete urethral stricture secondary to pelvic bone fracture or other causes during last 10 years. All patients underwent delayed endoscopic internal urethrotomy
(EIU0 3
to 9 months later after immediate suprapubic diversion. Prior to EIU, the antegrade-retrograde urethrogram demonstrated a complete urethral disruption, and he length of urethral obstruction was measured from 0.5cm to 3.5cm (mean 1.4cm).
Of 65 patients, 61 patients (94%) had successful operations, 4 patients 96%) whose strictures were measured more than 2.5cm were failed and treated wit open urethroplasty. Sixty-one patients who eventually underwent successful endoscopic internal
urethrotomy; 28 patients (46%) ahieved satisfactory urethral voiding after first EIU; 33 patients (54%) took operations more than twice due to recurred partial urethral stricure. After 6 to 53 months (average-21months), fifty-six (86%) of 65
patients
voided satisfactorily (incontinece in 3 patients). Five patients who did not void well even after successful EIU were diagnosed to have neurogenic bladder (detrusor areflexia0. Of 65 patients, 16 patients (25%) had post-traumatic impotence. After
the
EIUs were performed, there were no newely developed impotences. There were no serious major complications.
We concluded that direct visual internal urethrotomy was useful and safe as a primary minimally invasive therapeutic modality for post-traumatic complete urethral stricture in selected patients with relatively short urethral defect (less than
2.5cm).
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