前列腺增生症再手术原因分析

The reason of reoperation of benign prostatic hyperplasia

目的 :探讨前列腺增生症 (BPH)再手术的原因。方法 :回顾分析 2 6例 BPH术后再入院手术患者的临床资料 ,再手术原因为膀胱颈挛缩 1 3例、腺体残留复发 1 0例、前列腺癌 3例。结果 :对膀胱颈挛缩及腺体残留复发者均施行开放手术或经尿道电切治疗 ,术后尿路梗阻症状解除。 3例前列腺癌就诊已属晚期 ,施行去势术加氟他胺治疗 ,术后分别于 1 0～ 2 8个月因全身广泛转移导致衰竭而死亡。结论 :BPH开放手术后膀胱颈挛缩 ,TURP颈部切除不够或电灼较多等是 BPH术后再手术的主要原因。TURP术后腺体残留复发率远高于开放性手术 ,其主要原因为腺体切除不够或残留复发所致。

Purpose:To analyse the reason of reoperation of benign prostatic hyperplasia (BPH).Methods:Of 26 BPH patients accepted reoperation,13 patients with bladder neck contracture,10 patients with recurrence of BPH,3 patients with prostate cancer.Results:Both bladder neck contracture and recurrence of BPH were cured with open operation and TURP (Transurethral resection of the prostate).Prostate cancer patients were treated with orchiectomy or Flutamide,and died of metastasis in 10~28 months.Conclusions:The major reason of reoperation of BPH is bladder neck contracture after oper prostatectomy and bladder neck ablated too much or too little after TURP.Of recurrence rate of BPH,TURP is higher than open prostatectomy,the major reason is incomplete resection of prostate.