Madigan手术与经膀胱前列腺切除术术后尿动力学比较

A Comparative Study on the Urodynamic Results of Suprapubic Transvesical Prostatectomy and Madigan Prostectomy

为比较两种术式术后尿动力学改善的差异 ,将 2 6例Madigan手术与随机抽取的同期 35例经膀胱前列腺切除术术后进行尿动力学比较 ,术后拔尿管后 1周进行第 1次尿动力学检查 ,术后 4～ 6个月进行第 2次检查 .结果 :(1)初次尿意容量 (FD) :第 1次检查两组间有显著性差异 ,Madigan组大于经膀胱组 (P <0 0 1) ;第 2次检查两组间无显著性差异 (P >0 0 5) .(2 )逼尿肌不稳定 (DI)发生率 :第 1次检查两组间有显著性差异 ,Madigan组低于经膀胱组 (P <0 0 1) ;第 2次检查两组无显著性差异(P >0 0 5) .(3)急迫性尿失禁发生率 :第 1次检查两组间有显著性差异 (P <0 0 5) ,第 2次检查无显著性差异 (P >0 0 5) .结果表明 :逼尿肌不稳定是引起BPH术后患者临床症状的主要因素之一 ,Madi gan手术由于保持了膀胱颈及后尿道的完整性 ,其逼尿肌不稳定发生率低 ,有利于患者术后临床症状迅速改善 .

Toevaluate the two interventions by the urodynamic method postoperatively, urodynamic investigations were performed in 61 cases with clinical BPH after prostatectomy for 2 weeks and 4～6 months, respectively 26 of these were carried out with Madigan prostatectomy (Group 1), 35 of these were carried out with suprapubic transvesical prostatectomy (Group 2), which were randomized Results: Results of first investigation revealed that bladder capacity required evoke a first desire to void (FD), incidence of detrusor instability( DI ) and urge incontinence(UI) were significant different between two groups Group 2 FD was significantly decreased than group 1(P<0 01) Group 2 DI and UI were significantly increased than group 1(P<0 01) The second investigative results revealed that there were no significant difference between two groups(P>0 05) Conclusions: It was suggested that DI could be a role that caused clinical symptoms after prostatectomy The advantages of Madigan prostatectomy were the preservation of bladder neck and prostatic urethra, therefore, DI was decreased, It was beneficial to improve postoperative symptom