| Objectives To assess the effectiveness of direct vision internal urethrotomy with cold knife combined with plasma resection in male patients with simple urethral strictures and compare the effects with those obtained in patients treated with balloon dilation.Methods Retrospectively analyze 60 patients who were diagnosed with male simple urethral stricture from Sep 2010 to Sep 2015 in the affiliated hospital of Hebei University underwent surgical treatment. All patients were excluded preoperative, which had cardiopulmonary insufficiency or coagulation disorder dysfunction or blood pressure and blood glucose poorly controlled. Of which 34 cases from Sep 2010 to Sep 2014 were treated with direct vision cold knife urethrotomy combined with plasma resection(Cold knife group),and 26 cases from Sep 2014 to Sep 2015 were treated with balloon dilation(Balloon group).By looking at cases and follow-up data, there were some comparative indicators needed to observe as followings : patient's age status, course of disease, length of narrow segment,operative time, intraoperative blood loss, postoperative hospital stay, complications,recrudescence and so on. We compared the efficacy of two groups through statistical analysis.Result(1)The ages of cold knife group and balloon group were(46.26±12.91) and(44.12±12.06) years old respectively; the courses of disease:(4.59±3.98) and(4.59±3.98)years respectively; length of narrow segment:(1.79±0.71) and(1.62±0.69)cm respectively; Qmax:(6.22±2.31) and(5.77±2.40)ml/s respectively. Cold knife group had 17 cases with anterior urethra and 17 cases with posterior urethra, and balloon group had 10 cases with anterior urethra and 16 cases with posterior urethra. It was no significant difference in both two groups before the surgery, that the comparison of clinical characteristics(P>0.05),.(2) The operation time of cold knife group and balloon group were(33.24±9.84)min and(22.65±6.25)min, respectively; intraoperative bleeding volume:(16.76 ± 8.06)ml and(10.12±5.61)ml, respectively; hospital stay time:(3.94±1.54)d and(3.12±1.18)d,respectively; significant differences were found between the two groups(P<0.05).(3) There were no serious complications in two groups during the intraoperative and postoperative.There were 1 case of postoperative bleeding, 1 case of urinary incontinence, 1case got fever postoperative, 5 cases of urinary tract infections and 2 cases of epididymitis in Cold knife group. There were 1 case got fever postoperative, 2 cases of urinary tract infectionand 1 case of epididymitis in Balloon group surgery.The incidence of complication in two group were 29.4%(10)and 15.4%(3), separately; significant differences were found between them(?2=0.931,P>0.05).(4) All patients were followed up six month at least, which postoperative symptoms and quality of life were obviously improved compared with preoperative. The evaluation index in cold group, which was included the Qmax and QOL, were(15.82±4.82)ml/s and(2.35±0.92)in 3 months after the operation, were(5.95±5.21)ml/s and(5.95±5.21) in 6 months after the operation, all evidently improved compared with pre-operation(P<0.05). The evaluation index in balloon group, which was included the Qmax and QOL, were(16.31±3.52)ml/s and(2.06±0.89) in 3 months after the operation, were(16.42±3.63)ml/s and(2.15±1.21) in6 months after the operation, all evidently improved compared with pre-operation(P<0.05).The evaluation index in both groups, which was included the Qmax and QOL, were all evidently improved in post-operation compared with pre-operation and significant difference(P < 0.05). There was no significant difference in evaluation index between two groups(P>0.05).(5) The Cold knife group of 34 patients, 12 cases recurred, and the recurrence rate was35.3%; Balloon group of 26 patients, 5 cases recurred, and the recurrence rate was 19.2%;there were no significant differences between the two groups(?2=1.872,P>0.05).Conclusions(1) Trauma was still the main reason of urethral stricture, and iatrogenic injury had become the important cause of urethral stricture.(2) Direct vision balloon dilation for urethral stricture had the similar effect of recent surgery comparison with direct vision cold knife urethrotomy, which was effective in curing male simple urethral stricture.However, the long-term effection needed to further observe.(3) Balloon dilation for male simple urethral stricture was effective. The operation time,intraoperative blood loss and postoperative hospital stay in Balloon group were significantly less than DIVU, and its operation were simple and study-short period, which was worth to be popularized. |
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