雄犬功能尿道长度变化对尿动力学指标的影响

Urodynamic analysis of changed length of functional urethra in male dogs

目的评估功能尿道长度变化对尿道尿控的影响,探索预防前列腺根治术后尿失禁的新方法及其尿动力学依据。方法16只雄犬分成功能尿缩短组(A组)和膀胱肌管替代功能尿道组(B组),进行静态尿道压力图检查。结果A组在功能尿道逐步缩短时,尿动力指标逐渐下降,B组在用膀胱前壁肌管代替后尿道后,尿动力指标相应上升。两组在切除前列腺及远端2cm尿道后与术前尿动力指标差异显著(P<0.05)。结论功能尿道的长度与尿道控尿能力成正比,膀胱前壁带带肌管功能尿道重建术是预防前列腺根治术后尿失禁可供选择的方法。

Objective To evaluate the variation of functional urethra length on urine control, explore a new method to prevent urinary incontinence and seek urodynamic evidence after radical prostatectomy. Methods Sixteen male dogs, matched in body weight, were randomly divided into two groups. Group A were used to test the different rest urethral pressure profile after resection of prostate, resection of distant prostate plus posterior urethra in length of 1.5 cm and 2.0 cm respectively; Group B to test the different rest urethral pressure profile on pedicle myotube in length of 2.0 cm and 1.0 cm using anterior bladder flap respectively after resection of prostate and posterior urethra in length of 2.0 cm. Results The urodynamic indexes fell off while the functional urethra length decurtated gradually in group A, but they went up in group B. The two groups showed significant difference before and after the resection of prostate and distant urethra in length of 2.0 cm. Conclusion There was a direct ratio between the functional urethra length and the capability of urethral urine control. Reconstruction of functional urethra using anterior bladder flap pedicle myotube is a good choice to treat urinary incontinence after radical prostatectomy.