减少术后尿失禁及尿道狭窄的前列腺癌根治术(附42例报告)

Improved radical prostatectomy for prostate cancer to prevent urinary incontinence and urethral stenosis(report of 42 cases)

目的 探讨减少前列腺癌根治术后尿道狭窄及尿失禁的术式。 方法 采用膀胱颈粘膜外翻固定再与尿道对端吻合及保留膀胱颈环状肌纤维的前列腺癌根治术治疗前列腺癌 42例。 结果 42例术后均未发生膀胱尿道吻合口狭窄 ,尿失禁 2例。随诊 4～ 70个月 ,最大尿流率 2 5 .0～30 .7ml/s。 结论 采用膀胱颈粘膜外翻固定再与尿道对端吻合及保留膀胱颈环状肌纤维的前列腺癌根治术 ,术后避免或减少了尿道狭窄 ,减低尿失禁的发生。

Objective To evaluate the improved radical prostatectomy for prostate cancer in preventing postoperative urinary incontine nce and urethral stricture. Methods Retropubic radical p rostatectomy with extroversion fixation of bladder neck mucosa,end to end vesico urethral anastomosis and preservation of the bladder neck circular fibre have be en conducted for 42 prostate cancer patients. Results Al l the patients have been followed up for 4-70 months.There have been neither ve sicourethral stricture or total incontinence except slight incontinence in 2.The maximum urine flow rate has been 25.0～30.7 ml/s. Conclusions Radical retropubic prostatectomy with extroversion fixation of the bladde r neck mucosa,end to end vesicourethral anastomosis and preservation of the blad der neck circular fibre is beneficial in the prevention of postoperative urinary incontinence and vesicourethral stricture.