经尿道电切治疗小体积前列腺并膀胱颈挛缩疗效观察

The efficacy of transurethral electrocautery resection for small-volume benign prostatic hyperplasia and bladder neck contracture

目的 探讨经尿道电切治疗小体积前列腺并膀胱颈挛缩的疗效.方法 对19例下尿路梗阻临床症状明确的小体积前列腺增生患者及膀胱颈挛缩的患者进行经尿道前列腺切除术（TURP）及经尿道前列腺和膀胱颈电切术（TURBN）.结果 手术时间18-80min（平均36min）.术中出血约20-50 ml,无输血.术后无需膀胱持续冲洗.20～44 h后拔除导尿管（平均36h）.患者术中生命体征均较平稳,术中均未输血,未发生前列腺电切综合征,无同手术期死亡.随访19例,随访时间4～18月,术后1月,残余尿量由术前（226±1 9）ml降至（13.2 4±3.0）ml,IPSS由术前（21.9±3.5）分降至（7.8±2.25）分,最大尿流率由术前（7.9±2.0）ml/s升至（14.1±2.9）ml/s.尿道外口狭窄2例,海绵体部尿道狭窄1例,分别给予尿道外口切开及尿道扩张后治愈.结论 对于小体积前列腺增生合并膀胱颈挛缩患者实行TURP与TURBN相结合的方法 ,是目前安全可靠的手术途径.

Objective To explore the efficacy of transurethral electrocautery resection for small-volume benign prostate hyperplasia and bladder neck contracture.Method Transurethral resection of prostate combined with transurethral electrocautery resection of bladder neck was performed on 19 patients with obvious symptoms of urinary tract obstruction due to small-volume benign prostate hyperplasia and bladder neck contracture.Results The symptoms of obstructin was effectively relieved in all the patients.Conclusion Transurethral resection of prostate combined with transurethral electrocautery resection of bladder neck is a safe,reliable surgical procedure for small-volume benign prostate hyperplasia and bladder neck contracture.