前列腺增生症术后排尿困难原因分析与治疗

Causes and Treatment of Dysuria After Operation for Benign Prostate Hyperplasia

目的：探讨前列腺增生症（BPH）术后排尿困难的原因和治疗方法。方法：回顾性分析总结25例BPH术后排尿困难患者的临床资料和处理方法。结果：排尿困难的原因有膀胱颈水肿、膀胱颈狭窄、腺体残留复发、神经源性膀胱、前列腺癌。20例再手术治疗，3例行尿道扩张，随访1～12个月均排尿通畅。2例长期留置耻骨上膀胱造瘘。结论：膀胱颈狭窄是前列腺增生症术后排尿困难的主要原因。腔内手术是治疗膀胱颈狭窄或腺体残留复发的首选方法。

Objective： To analyse the causes and treatment of dysuria after operation for benign prostate hyperplasia （BPH）. Methods： Clinical data and therapeutic methods in 25 BPH cases were retrospectively analysed and summarized. Results： The causes of dysuria included edema and stenosis in neck of bladder, recurrence of BPH, the neurogenic bladder and prostate cancer. Of 25 cases, 20 cases were reoperated and 3 underwent urethral expand. Followed up between 1 and 12 months, all cases recovered urination and 2 of 25 cases remained suprapuhie bladder fistullization. Conclusion：The stenosis in neck of bladder is the major cause of dysuria after operation for BPH. Endourethral surgery is effective in treating stenosis in neck of bladder and recurrence of BPH.