Abstract:
Objective To observe effect of guiding wire method under soft cystoscopy in treatment of urethral stricture caused by acute closed injury of urethral bulb.
Methods A total of 74 patients with urethral stricture caused by acute closed injury of the urethral bulb were selected as study objects, the urethral dilatation treatments were performed by the guiding wire method under soft cystoscopy. The operation time, intraoperative blood loss, hospital stay, Visual Analogue Scale(VAS)score during postoperative indwelling catheterization, incidence of urethral stricture 6 months after catheter removal, the times of urethral dilatation, maximum urine flow rate, and complications were observed.
Results A total of 70 cases undergoing urethral dilatation were successfully performed, 2 cases formed a retrograde blind cavity(prosthesis)or valve due to severe damage to the membrane and anterior urethra, and 2 cases developed "pinhole-like" stenosis of the urethra due to third-degree prostatic hyperplasia, the guiding wire was repeatedly inserted but failed to pass causing urethral dilatation failure. The operation time of the patients was(43.93±6.54)min, the intraoperative blood loss was(64.34±5.38)mL, and the hospital stay was(5.36±0.76)days, the VAS score during the postoperative indwelling catheter was(3.98±1.02). The incidence of urethral stricture 6 months after removal of the catheter was 5.41%, and the number of urethral dilatation was(7.15±1.06)times, the maximum urine flow rate was(19.98±2.68)mL/s. No serious complications such as rectal injury,bladder injury and perforation, true urinary incontinence occurred during the operation and 6 months after operation, 1 case occurred a small amount of bleeding due to minor damage to the - urethral mucosa(the bleeding was stopped after hemostasis)and 2 cases had a minor urethral infection, and infection was controlled by routine anti-infection treatment.
Conclusion The guiding wire method under soft cystoscopy has a significant effect in the treatment of urethral stricture caused by acute closed injury of the urethral bulb. Urethral dilatation has higher success rate, less injury to patients and fewer complications.