经尿道前列腺电切术后再入院的原因及治疗探讨

Causes and management of readmission after transurethral prostatcetomy for BPH (report of 30 cases).

目的分析经尿道前列腺电切(TURP)术后患者再入院的原因,探讨治疗方法。方法TURP术后再入院患者30例。腺体残留或复发12例,10例再次行TURP;尿道狭窄8例,3例行尿道扩张术,3例行尿道内切开,1例行尿道外口成形术,1例行耻骨上膀胱造瘘术;TURP术后继发出血6例,行经尿道膀胱冲洗加电凝止血;神经原性膀胱功能障碍1例,行耻骨上膀胱造瘘术;前列腺癌2例,行睾丸切除术;TURP术后尿失禁1例,使用阴茎集尿器。结果30例患者23例行手术治疗,术后随访8个月至7年,平均随访3.5年。效果满意21例(91.3%),2例尿道狭窄术后需要定期尿道扩张。结论术前准确诊断,合理选择手术方式及术中术后正确处理是预防患者术后再次入院的关键。

Objective To investigate the causes of readmission after transurethral prostatcetomy （TURP）for benign prostatic hyperplasia （BPH） and the treatment approaches. Methods Data of 30 patients eligible for the study were reviewed. 12 patients had residual tissue and recurrent BPH,of these patients, 10 underwent a second TURP. 8 patients developed urethral stricture, of these patients, 3 patients underwent urethral dilatation, 3 patients underwent internal urethrotomy, 1 patient underwent meatoplasty and 1 patient underwent suprapubic cystostomy. 6 patients had bleeding after TURP, all the patients underwent transurethral bladder flush and electric coagulation hemostasis. 1 patients had neurogenic bladder dysfunction, this patient underwent suprapubic cystostomy. 2 patients had prostatic cancer, Both patients underwent orchidectomy. 1 patients had incontinence after TURP, the patient used external collection device. Results Of these 30 patients, 23 patients underwent operations. The mean follow--up period was 3 years and 6 months （range： 8 months to 7 years） and 21（91.3%）of them got satisfactory results. 2 patients with urethral stricture required regular urethral dilation after surgery. Conclusion Correct preoperative diagnosis, rational operative procedures and correct intraoperative and postoperative management are key to preventing readmission.