前列腺电切及汽化电切术后再入院原因及对策

The cause and management of readmission after transurethral prostatectomy

目的探讨前列腺增生症(BPH)行前列腺电切(TURP)及汽化电切(TUVP)术后再入院的原因及防治措施。方法分析32例TURP及TUVP术后再入院的原因及诊治情况。结果32例中,尿道狭窄12例,经尿道扩张术,尿道口成形术或尿道内切开术好转;继发出血9例,经保守治疗或电切镜电凝止血;腺体残留7例,再次行TURP术;前列腺癌(PCa)2例,已至局部晚期,行睾丸切除术+内分泌治疗。永久性尿失禁2例,行球部尿道折叠加阴茎脚包埋术。结论尿道狭窄,继发出血,腺体残留是再入院的主要原因,经尿道手术是解决问题的有效方法。

Objective To analyze the causes and management of readmission in patients after transurethral resection of the prostate（TURP） or transurethral electrovaporizafion of the prostate（TUVP）. Methods The clinical data of 32 patients who were rehospitalized after TURP or TUVP were analyzed. Results 12 cases developed urethral stricture, being treated with urethral dilation, urethral orifice reconstruction or transurethral cold knife incision plus electric resection of scar. Transurethral bladder washing and oagulating or nonoperation underwent in 9 postoperative severe bleeding, TURP in 7 residual and recurrent adenoma, orchiectomy plus hormone thera- py in 2 prostate cancer, bulbourethral plication plus penile crural compressin in 2 urinary incontinence patients. Condusion Urethal stricture, postoperative severe bleeding, residual and recurrent adenoma are the main causes of readmission in patients after TURP or TUVP. Transurethral surgery is most favorable treatment choice for readmitted patients after prostatectomy.