综合手术治疗逼尿肌无反射性神经原性膀胱(附10例报告)

One-stage combined operation for treatment of neurogenic bladder of detrusor urinae areflexia

本组报告10例,采用经尿道内括约肌切断术和腹直肌转位术的综合手术治疗尿道内括约肌痉挛型的逼尿肌无反射性神经原性膀胱。手术特点:能解除膀胱出口梗阻,改善膀胱逼尿肌的功能障碍。术后病人能自行排尿,术前反复发作急性尿路感染术后均得到控制,术后血肌酐、尿素氮正常者9例,术后残余尿量均小于50ml,最大尿流率15～20ml/s,最大尿道闭合压较术前平均下降7.42kPa,功能性尿道长度较术前平均缩短2cm。

10 patients with the neurogenic bladder of detrusor urinae areflexia and Urethral internal Sphincter spasm have been treated by one-stage transurethral internal sphincterotomy combined with the displacement of flap of abdominal rectus. The operation can not only decrease outlet resistance of bladder but also improve disfunction of the bladder voidding. All postoperative patients can Void normally, preoperative a-cute urinary infection have been controlled. The level of blood BUN and Cf of 9 cases become normal postop-eratively. The residual urine of all patients are less than 50 ml, the maximum urine flow rate are 15~20 ml/ sec, the maximum urethral close pressure decreased by 7. 42 kPa and functional urethral length deceased by 2 cm at postoperative period.