经尿道前列腺电切与双极等离子电切对前列腺电切术后尿道狭窄的影响

Effect on urethral stricture after transurethral resection versus plasma kinetic resection of the prostate for the treatment of BPH

目的研究经尿道前列腺电切术(TURP)和双极等离子电切术(PKRP)治疗前列腺增生(BPH)与术后尿道狭窄的关系。方法对59例接受TURP患者,36例接受PKRP患者的临床资料进行回顾性研究,分析手术时间、术后冲洗时间、留置尿管时间、术后住院时间、术后6个月尿常规白细胞数等指标与相应的尿道狭窄发生率的关系。结果术前两组一般情况比较无统计学差异(P>0.05);手术时间、术后冲洗时间、留置尿管时间、术后住院时间、术后6个月尿常规白细胞数,PKRP组明显优于TURP组(P<0.05)。术后6个月中,TURP组有10例发生尿道狭窄(16.9%),而PKRP组则仅为1例(2.8%)(P<0.05)。Logistic回归分析,TURP组术后留置尿管时间是影响尿道狭窄的主要危险因素,PKRP组各指标对尿道狭窄的发生无明显差异。结论 TURP术后留置尿管时间是导致尿道狭窄的主要因素。PKRP术后尿道狭窄发生率明显低于TURP,有良好的应用前景。

Objective To study the clinical effect on urethral stricture after transurethral resection（TURP） versus plasma kinetic resection of the prostate（PKRP） for the treatment of BPH. Methods Clinical data of 59 cases who underwent TURP and 36 cases who underwent PKRP were analyzed retrospectively and confirmed the correlation between incidence of urethral stricture and clinical factors including operative time, bladder irrigating time, catheter detain time,hospitalization time and quantity of WBC in urine 6 months postoperatively. Results There was no significant difference of preoperative factors between the two groups（P0.05）. Operative time, bladder irrigating time, catheter detain time, hospitalization time and quantity of WBC in urine 6 months postoperatively were improved in PKRP than in TURP（P0.05）.Urethral stricture occurred in 16.9% of TURP and in 2.8% of PKRP in 6 months postoperatively（P0.05）.Analysis of Logistic showed catheter detain time was the main cause of urethral stricture after TURP,otherwise no factor exerted effect on urethral stricture after PKRP. Conclusion Catheter detain time was the main cause of urethral stricture after TURP, and shorter catheter detain time can reduce incidence of urethral stricture. PKRP has lower incidence of urethral stricture than TURP, and may have a promising future.