广州医科大学学报

目的:探讨输尿管镜下膀胱颈电切术治疗小儿先天性膀胱颈梗阻的临床价值。方法:回顾性分析2008年6月至2011年12月广州医学院第一附属医院泌尿外科收治的6例行输尿管镜下膀胱颈电切术的小儿先天性膀胱颈梗阻患者的临床资料。6例患儿均为男性,平均年龄6.5岁,主要表现为排尿困难、膀胱输尿管返流和膀胱颈后唇抬高。在8.0/9.8F输尿管硬镜直视下用电切杆在5点及7点处纵行切开,切除5点至7点间增生的膀胱颈组织。结果:术后平均随访21.5个月,6例患儿肾功能均维持正常,MFR(12.6±1.6)mL/s,肾脏B超检查示双肾轻度积液,无尿失禁,未再次出现膀胱颈梗阻。结论:输尿管镜下膀胱颈电切术治疗小儿先天性膀胱颈梗阻的近期疗效良好,远期疗效尚不明确,有待进一步随访。

Objective:To explore the clinical significance of ureteroscopic transurethral bladder-neck resection in children with congenital bladder-neck obstruction.Methods:We did a retrospective analysis on the clinical profiles of 6 male children(mean age:6.5 years) with congenital bladder-neck obstruction treated with ureteroscopic transurethral resection between June 2008 and December 2011 in the department of urology,First Affiliated Hospital of Guangzhou Medical College.These children mostly presented with dysuria,vesico-ureteral reflux and bladder posterior lip elevation.The bladder-neck hyperplasia tissues anatomically positioned between points five and seven in the circle were longitudinally incised followed by removal via electrocautery probe under 8.0/9.8 F ureteroscope.Results:In the mean follow-up period of 21.5 months,all children presented normal renal function with exception of mild renal hydronephrosis as revealed by ultrasonography,with the maximum urinary flow-rate of(12.6±1.6) mL/s.Neither incontinence nor recurrent bladder-neck obstruction was reported.Conclusion:Ureteroscopic transurethral resection has achieved preferable short-term efficacy for the treatment of congenital bladder-neck obstruction in children.The long-term impact,however,is undetermined and deserves further follow-up studies.