经尿道前列腺电切术后排尿困难的原因分析及治疗(附22例报告)

Causes and Treatment of Dysuria post Trans-urethral Resection of Prostate(Report of 22 Cases)

目的分析经尿道前列腺电切术（TURP）后排尿困难产生的原因，并探讨相应的预防和治疗措施。方法对22例TURP术后排尿困难的患者的临床资料进行回顾性分析，经B超、尿道探试、尿道造影、膀胱尿道镜及尿流动力学检查诊断为前尿道狭窄7例，膀胱颈狭窄和挛缩各2例，腺体残留4例，后尿道狭窄3例，组织碎片或血块阻塞2例，膀胱颈和尿道水肿2例。对患者均先行尿道扩张，并针对不同原因采取重新电切、膀胱冲洗、重置尿管并抗炎治疗，治疗后随诊3～6个月。结果根据不同的原因采取相应的治疗方法，所有患者排尿困难的症状均明显改善。结论排尿困难是TURP术后的常见并发症，应根据不同的原因采取相应的预防及治疗措施；尿道扩张和微创处理是安全有效的治疗方法。

Objective To study the causes and treatment of dysuria post trans-urethral resection of prostate （TURP）, and discuss how to prevent and treat this complication. Methods The clinical data and the treatment of 22 cases of dysuria post TURP were analyzed retrospectively. By using B-ultrasonograghy, sounding of urethra, urethrograghy, cystourethroscopy and urodynamic study, 7 cases of anterior urethral stricture, 4 cases of vesical neck constriction and bladder neck contracture, 4 cases of adenoma left, 3 cases of posterior urethral stricture, 2 cases of blockage of tissue chip or blood clot and 2 cases of bladder neck＇s and urethral dropsy were diagnosed. All patients were treated with urethral sounding chiefly, and then re-TURP, bladder washout, urinary catheterization and anti-inflammatory treatment, etc. were used according to the different etiopathogeniesis, and followed up for 3-6 months. Results By corresponding treatments according to the different etiopathogeniesis, the symptoms of the patients with dysuresia were improved significantly. Conclusion Dysuresia is a common complication post TURP caused by different etiopathogeniesis. Urethral sounding and minimum invasive procedures are the safe and effective treatments.