前列腺增生术后排尿障碍经直肠超声的评价

Clinical Evalue of Transrectal Ultrasound on Urination Disorders in Patients with BPH after Prostatectomy

目的探讨前列腺增生术后排尿障碍经直肠超声检查的临床诊断价值。方法经直肠超声(TRUS)观察70例前列腺增生术后排尿障碍患者的声像图表现(包括前列腺术后改变及残存或再发病变)并与手术结果、X-线尿道造影、尿道探条及膀胱镜检查结果对照分析其诊断价值。结果尿道狭窄、膀胱颈挛缩的TRUS诊断符合率为84%(26/31)及90%(20/22);腺体残留并复发增生、后唇抬高、血凝块及腺体碎屑物阻塞、继发膀胱结石等符合率为100%;TRUS同时检出弱回声灶并提示癌性占位病变6例。结论TRUS可用于观察前列腺增生术后残存腺体(大小、形状、内部回声等)、尿道前列腺部及膀胱的变化表现,对术后排尿障碍的原因诊断有较高准确性,尤其对有多种梗阻原因并存的术后患者和早期前列腺癌的诊断有较大优势。TRUS应成为BPH术后检查的首选方法。

Objective To investgate the clinical value of transrectal ultrasound on urination disorders in patients with BPH after prostatectomy. Methods TRUS was used to observe 70 cases with BPH after prostatectomy to evaluate the diagnostic value in urination disorders and was compared with operation, cystourethrography or cystoscopy. Results The diagnostic rate of bladder neck contracture and urethral stricture was 84~ （26/31） and 90~ （20/22） respectively, The diagnostic coincidence of TRUS for residues or recurrence, posterior bladder lip lifting, blood clots or bladder stones was 100% （11/11）. Six cases with prostatic cancer with weak echoes were confirmed by histopathology after operation. Conclusions TRUS can be used to observe the related changes of prostate and the prostatic urethra after prostatectomy;A relatively high accuracy can be achieved using TRUS to diagnose the residual or recurrent diseases of the prostate after prostatectomy.