两种术式治疗耻骨上经膀胱前列腺摘除术后膀胱颈挛缩的疗效比较

Comparison of Therapeutics on Bladder Neck Contracture Following Prostatectomy by Suprapubic Approach

目的比较治疗耻骨上经膀胱前列腺摘除术后膀胱颈挛缩的两种手术方法的效果。方法采用病例对照研究,开放手术组26例,行开放膀胱颈后唇楔形切除术或后楔形切除加Y-V成形术,经尿道电切组18例,行经尿道膀胱颈电切术。结果开放手术组平均手术时间为(119.8±20.5)m in,术中出血量平均(91.2±30.8)m l,治愈率为80.8%,并发症发生率为26.9%,术后IPSS评分为(11.5±5.2)分;经尿道膀胱电切组平均手术时间为(20.1±3.7)m in,术中出血量平均(5.5±4.0)m l,有效率100%,并发症发生率5.6%,术后IPSS评分为(7.5±1.5)分,明显优于开放手术组(P<0.05)。结论经尿道膀胱颈电切术治疗耻骨上经膀胱前列腺摘除术后膀胱颈挛缩,其梗阻解除彻底,创伤小,出血少,并发症少,恢复快,是一种较好的治疗方法。

Objective To compare the method and effect of bladder neck contracture following prostatectomy by suprapubic approach. Methods 44 patients underwent bladder neck contracture following prostateetomy by suprapubic approach were diveded into 2 groups ： 26 cases as open operation group underwent open bladder neck wedge resection of posterior lip or wedge resection of posterior lip and Y-V formation and 18 cases undwent transurethral resection of bladder neck（TURN） as TURN group. Results The mean operation durum, blood loss volume in operation, cure rate, complication incidence and IPSS score was 119.8 ±20.5 min, 91.2 ±30.8 ml, 80.8%, 26.9%, 11.5 ±5.2 in open group respectirely, and 20.1 ±3.7 rain, 5.5 ±4.0 ml, 100%, 5.6%, 7.5 ± 1.5 in TURN group respectively. All the data showed that of TURN group better than open group （ P 〈 0.05 ）. Conclusion TURN is a reasonable treatment method with good therapeutic effect, reduced bleeding, less complication and improved recovery for the bladder neck eontraeture following prostateetomy.