良性前列腺增生与下尿路症状及急性尿潴留的关系

Correlation of BPH with LUTS and AUR

目的 探讨前列腺移行带增生与下尿路症状 (LUTS)及急性尿潴留 (AUR)的关系。方法 将 119例良性前列腺增生(BPH)患者按有无AUR及LUTS严重程度分为 3组 :无AUR但LUTS较重者为A组 ,有AUR且LUTS较重者为B组 ,有AUR但LUTS较轻者为C组。对各组行I PSS评分 ,测量F PSA、T PSA及F/T PSA ;耻骨上经膀胱切除前列腺时观察移行带向膀胱内突出情况及前列腺部尿道狭窄情况 ,术后测定移行带质量 (TZW ) ,计算移行带体积 (TZV)。结果 各组F/T PSA、TZW、TZV差别无统计学意义 (P >0 .0 5 )。A、B两组I PSS评分及前列腺部尿道狭窄百分比明显高于C组 (P <0 .0 5 ) ;A组F PSA、T PSA、移行带向膀胱内突出百分比明显低于C组 (P <0 .0 5 ) ,而B、C两组这 3项指标无明显差异 (P >0 .0 5 )。A组F PSA、T PSA明显小于B组 (P <0 .0 0 1) ,I PSS、前列腺部尿道狭窄及移行带向膀胱内突出百分比与B组无显著性差异 (P >0 .0 5 )。结论 前列腺移行带质量及体积与BPH引起的LUTS及AUR的发生无关 ;而移行带的增生使前列腺部尿道狭窄、延长是BPH引起的LUTS的主要原因 ;移行带向膀胱突出则是AUR的主要原因。BPH合并AUR的患者F PSA及T PSA均明显增高 ,F/T PSA变化则不明显。

Objective To study the relationship of prostate transition zone (TZ) with lower urinary tract symptom (LUTS) and acute urinary retention (AUR). Methods A total of 119 cases of benign prostatic hyperplasia (BPH) were divided into 3 groups: without AUR but severe or high-moderate symptoms (group A), with AUR and severe or high-moderate symptoms (group B), with AUR and non-mild or low-moderate symptoms (group C). All the patients underwent suprapubic prostatectomy. All parameters were performed and the data were evaluated with statistical analysis. Results Among the 3 groups F/T-PSA, TZ weight and TZ volume had no significant differences (all P>0.05). I-PSS score and the percentage of urethra stricture in prostatic portion of group C were significantly lower than those of groups A and B (P<0.05). F-PSA, T-PSA and the percentage of intravesical transition zone projection of group C were higher than those of group A (P<0.05), but they did not significantly differ between group B and C (P>0.05). F-PSA and T-PSA of group A were lower than those of group B (P< 0.001 ), but there was no significant difference in I-PSS, percentage of urethral stricture in prostatic portion and the percentage of intravesical transition zone projection between group A and group B .Conclusion TZ weight and TZ volume have no correlation with LUTS and AUR. It is the main cause of LUTS in BPH that the hyperplasia of transitional zone makes stricture and prolongation of urethra in prostatic portion; AUR of BPH patients is the main result of intravesical transition zone projection. Except F/T-PSA, F-PSA and T-PSA are significantly increased in BPH complicated with AUR.