女性膀胱颈纤维化导致膀胱出口梗阻的诊治(附22例报告)

Diagnosis and treatment of bladder outlet obstruction in female caused by bladder neck fibrosis(report of 22 cases)

目的报告女性膀胱颈纤维化导致膀胱出口梗阻（BOO）的诊断治疗体会。方法膀胱颈纤维化导致BOO女性病例22例，经尿流动力学及膀胱镜检确诊，均行经尿道膀胱颈部分切除术，并联合药物治疗。结果随访2～15个月，排尿情况均有改善，最大尿流率〉15mL／s，国际前列腺症状评分（IPSS）5．2±1．6。病理报告显示所有病例膀胱颈组织纤维增生，其中合并慢性炎症改变10例。结论根据临床症状、尿流动力学检查及膀胱镜检可以明确诊断膀胱颈纤维化导致的BOO，经尿道膀胱颈部分切除术可以取得良好的治疗效果。

Objective To present experience on the diagnosis and treatment of bladder outlet obstruction （BOO） in female caused by bladder neck fibrosis. Methods All 22 patients were diagnosed by symptoms, urodynamic test and cystoscopy, and treated by transurethral partial resection of the cervix vesicae combined with alphal-adrenoeeptor antagonists. Results The patients were followed up for 2-15 months. Urination was improved; maxim urine flow rates after operation were more than 15 mL/s. and IPSS scores were （5.2± 1.6）. Fibroblast proliferation was noted in all the cases and chronic inflammation in 10. Conclusion Clinical symptoms, urodynamic test and cystoscopy are the reliable diagnostic methods for BOO caused by bladder neck fibrosis in women. Transurethral partial resection of the cervix vesicae can produce optimistic results.