支架植入术治疗前列腺电切术后排尿障碍的疗效观察

Observation on the Efficacy of Stent Implantation for the Treatment of Urination Disorder after Transurethral Resection of Prostate

[目的]观察超声引导下镍钛记忆合金网状支架植入术治疗经尿道前列腺电切术后排尿障碍的效果.[方法]对46例良性前列腺增生行经尿道前列腺等离子电切术后复发排尿障碍患者局麻下经超声引导置入镍钛记忆合金支架,观察治疗效果.[结果]46例患者中42例手术成功,支架置入后3~7 d拔除导尿管,42例患者恢复自主排尿,残余尿量明显减少,尿流率正常或接近正常,有效率为91.3%,国际前列腺症状评分（IPSS）、最大尿流率（Qmax）、残余尿量（RUV）分别为（9.2±2.1）分、（16.5±1.1）mL/s、（19.6±5.8）mL,2例因尿道狭窄未能植入支架行膀胱造瘘,2例因严重的尿路刺激症状及血尿取出支架.[结论]超声引导下镍钛记忆合金网状支架治疗前列腺电切术后复发排尿障碍效果确实,适用于高危的前列腺电切术后复发患者.

[Objective]To observe the efficacy of ultrasound-guided nickel-titanium memory alloy mesh stent implantation for the treatment of urination disorder after transurethral resection of prostate. [Methods] Totally 46 patients with recurrent urination disorder after transurethral resection of prostate for benign prostatic hyperplasia underwent ultrasound-guided nickel-titanium memory alloy stent implantation under local anesthesia. The efficacy was observed. [Results]In 46 patients, 42 patients operated successfully. Urethral catheter was extracted 3-7 days after stent implantation. All 42 patients recovered automatic micturition, and residual urine volume（RUV） decreased obviously, and urine flow rate was normal or near normal. The effective rate was 91.3 %. International prostate symptom scale（IPSS）, maximum urine flow rate（Qmax） and RUV were （9.2±2.1） scores, （16.5±1.1）mL/s and （19.6±5.8）mL, respectively. Two cases of urethral stricture failed to implant stents and turned to undergo cystostomy. Two cases received the removal of stent due to severe urinary tract symptoms and hematuria. [Conclusion] Ultrasound-guided nickel-titanium memory alloy mesh stent for the treatment of recurrent urination disorder after prostate transurethral resection is effective and can be applied in the treatment of high-risk recurrent patients after prostate transurethral resection.