改良Madigan前列腺切除术的治疗体会

Therapeutic understanding of modified Madigan prostectomy

目的介绍改良Madigan前列腺切除术的治疗体会。方法改良mMadigan前列腺切除术治疗BPH32例,°20例、°12例。患者均有明显地进行性排尿困难史或以往有尿潴留史;经B超及膀胱镜检查示前列腺中叶向膀胱内增生者(但均不超过1.0 cm)25例,输尿管开口正常间嵴无增厚,无膀胱结石及憩室等并发症;血PSA均低于4.0μg/l,均有明显手术指征;国际症状评分(I^PSS)15~30分、平均22.5分,生活质量评分3~6分、平均4.5分。结果32例手术均顺利。手术时间35~55 min、平均45 min;切除腺体重量30~100 g、平均65 g;术中出血10~60 ml、平均出血量35 ml;术后留置尿管时间5~7 d;住院时间5~7 d。国际症状评分(I^PSS)0~8分、平均4分;生活质量评分0~2分、平均1分;平均最大尿流率均大于15 ml/s。术后随访时间2~12个月、平均7个月,25例性生活较术前改善,无阴茎勃起功能障碍,无排尿困难。结论改良Madigan前列腺切除术术式简单,无明显出血,术后恢复快,住院时间短,花费少,尤其是对性功能无明显影响。

Objective To understand modified Madigan prostectomy in clinical practice. Methods 32 cases with BPH underwent modified Madigan prostectomy. The ages ranged between 58 to 80 years;Type Ⅱ° were 20 cases and type Ⅲ° 12 cases. 25 cases had middle leaf growing in bladder;I-PSS was 15-30 points（average,22.5 points） ;Grade of living quality was 3- 6 points（average,4.5 points） ;Blood PSA was lower than 4.0μg/l. Results All operations were successful with operative time between 35- 55 minutes （average, 45 minuts）. The cut prostate weighed 30- 100 g （average, 65 g）. The bleeding amount was 10- 60 ml （average, 35 ml）. The average hospitalization was 5 - 7 d. I-PSS was 0-8 points （average, 4 points）. Grade of living quality was 0- 2 points （average, lpoint）. Follow-up for 2 12 months showed better sexuallife than before,no erectile dysfunction,and the passing was good. Conclusion This operation is simple, with less bleeding, faster recovery, shorter hospitalzation, few complications, and few influences on sexual function.