经尿道前列腺电切术后排尿困难38例分析

Analysis of 38 patients with difficulty of urination after TURP or TUVP

目的:探讨经尿道前列腺电切或电气化术(TURP/TUVP)治疗后发生排尿困难的原因及处理方法。方法:对38例经TURP/TUVP治疗术后发生排尿困难的良性前列腺增生(BPH)患者进行综合分析,找出排尿困难的原因,行手术或单纯行尿道扩张治疗,术后随访观察治疗效果。结果:排尿困难的原因有膀胱颈口狭窄、挛缩、尿道狭窄、腺体残留或增生复发、膀胱逼尿肌乏力、神经原性膀胱机能障碍、功能性膀胱出口梗阻、恶变等。术后随访1月～5年,平均33个月,36例排尿恢复通畅,2例行耻骨上膀胱造瘘术。结论:术前进行膀胱功能评价、术中仔细操作、术后加强管理,对减少TURP/TUVP术后发生排尿困难具有重要意义。

Objective：To explore the causes and treatment of difficulty of urination after TURP or TUVP.Methods：38 cases with difficulty of urination after TURP or TUVP were reviewed.The causes of difficulty of urination were bladder outlet stricture,urethral stricture,relapse of BPH,the bladder detrusor dysfunction,functional bladder outlet obstruction,prostate cancer.Results：36 cases were surgically managed,2 cases treated by urethral sounding,The follow-up time was 1～60 months with a mean of 33 months,36 cases of them urinate normally,and 2 cases treated by suprapubic cystostomy.Conclusions：Preoperative bladder functional evaluation,operating carefully and strengthening of management after operation are key points in preventing postsurgical difficulty of urination after TURP or TUVP.