超声检查在经尿道前列腺等离子电切术后再次排尿困难诊断中的价值

Clinical value of sonourethrography in the diagnosis of dysuria after bipolar transurethral plasmakinetic prostatectomy

目的 评价超声检查诊断经尿道前列腺等离子电切术后再次排尿困难的可靠性。方法2006年7月至2010年1月采用经尿道等离子电切术治疗的术后再次出现排尿困难的BPH患者60例。年龄61～87岁，平均73岁。术后1个月-3年，再次排尿困难1～3个月。60例均行超声和尿道镜检查，给予膀胱颈瘢痕电切、尿道狭窄冷刀切开、前列腺切除、尿道激光碎石、尿道扩张等处理。结果超声检查发现膀胱颈闭锁11例，膀胱颈口狭窄10例，尿道膜部狭窄16例，尿道海绵体狭窄12例，前列腺腺体残留5例，尿道前列腺部结石1例，尿道内口活瓣1例，均与尿道镜检查结果相符。超声检查未发现异常4例，其中行尿道镜检查发现尿道外口狭窄2例，行尿道镜检查和尿流动力学检查发现膀胱逼尿肌功能障碍2例。结论超声检查是经尿道前列腺等离子电切术后再次排尿困难可靠的诊断方式，有助于指导术后再次排尿困难的临床处理。

Objective To evaluate the value of sonourethrography in the diagnosis of dysuria after bipolar transurethral plasmakinetic prostatectomy. Methods Sixty male patients with dysuria after bipolar transurethral plasmakinetie prostatectomy underwent sonourethrography and re-operation. The clinical data of these patients were reviewed. Results The sonourethrographic findings were similar with the operative findings in 57 cases. In the 60 cases, there were 11 cases with bladder neck closure, 10 cases with bladder neck stricture, 30 cases with urethral stricture （16 located at membranous urethra, 12 located at pars cavernosa urethra and 2 in external orifice of urethra） , 5 cases with prostate remnant, 1 case with calculi in pros- tatic urethra, 2 eases with dysfunction of detrnsor of bladder and 1 case with flap of internal urethral orifice. Conclusions Sonourethrography could be a reliable diagnostic method for dysuria after bipolar transurethral plasmakinetie prostateetomy. It may be helpful for clinical treatment.