膀胱颈纤维组织增生性梗阻的诊断和治疗(附30例报告)

Diagnosis and treatment of bladder outlet obstruction caused by bladder neck fibrosis (report of 30 cases)

目的 报道膀胱颈纤维组织增生导致的膀胱出口梗阻 (BOO)的诊治体会。 方法 总结膀胱颈纤维组织增生BOO病例 30例 ,均行经尿道膀胱颈部切开或膀胱颈部分切除术 ,并联合应用α1受体拮抗剂如哈乐、特拉唑嗪或哌唑嗪治疗。 结果 30例病人随访 3～ 30个月 ,排尿情况均有不同程度改善 ,平均尿流率 >15ml/s,IPSS评分 5 .3± 1.7(术前 2 5 .4± 4.2 ) ,生活质量评分 1.4± 0 .6(术前 4.1± 0 .8)。病理检查示 30例有不同程度纤维组织增生 ,其中 18例有慢性炎性改变。 结论根据临床症状、压力 流率测定和膀胱镜检诊断膀胱颈纤维组织增生性梗阻简便有效 。

Objective To present experience on the diagnosis and treatment of bladder outlet obstruction (BOO) caused by bladder neck fibrosis. Methods 30 cases of BOO caused by bladder neck fibrosis were studied. All the patients were treated by transurethral partial resection or incision of the cervix vesicae combined with alpha 1 adrenoceptor antagonists such as tamsulosin and terazosin or parazosin. Results Urination has been improved in all.The patients have been followed up for 3 to 30 months.On repeated uroflowmetry,the 30 patients showed the urine flow rates have been more than 15ml/s. IPSS scores was 5.3±1.7(25.4±4.2 preoperative) and quality of life scores was 1.4±0.6(4.1±0.8 preoperative).Fibroblast proliferation was noted in all the 30 and obvious chronic inflammation in 18. Conclusions Clinical symptoms, pressure rate measurement and cystoscopy are the reliable diagnostic methods.Transurethral partial resection or incision of cervix vesicae combined with alpha 1 adrenoceptor antagonists is effective.