前列腺增生伴逼尿肌无力患者的电切术治疗

Transurethral resection of the prostate in BPH with acontractile detrusor

目的 :探讨良性前列腺增生 (BPH)伴有逼尿肌无力 (ACD)患者的治疗方法和效果。方法 :对尿动力学检查确认有ACD的 12例BPH并发膀胱出口梗阻 (BOO)的患者 (A组 )进行经尿道前列腺电切术 (TURP)或加膀胱颈内切开术 (TUIBN) ,同时与逼尿肌功能正常或高于正常的行TURP的BPH患者 2 4例 (B组 )进行对照分析。结果 :A组术后 7～ 30d复查 ,国际前列腺症状评分 (IPSS)为 12 .5 8± 0 .70分 (P <0 .0 0 1) ,最大尿流率 (Qmax)为11.0 5± 0 .85ml/s (P <0 .0 5 ) ,均比术前有改善 ,但术后效果不如B组明显 (P <0 .0 0 1)。术后 3、6个月复查IPSS及Qmax,两组略有改变 ,但差异无显著性意义 (P >0 .0 5 ) ,剩余尿测定也均在正常范围。术后 3个月对ACD的 5例复查逼尿肌收缩力 ,无明显改善。结论

Purpose:To investigate the treatment method and effect of benign prostate hyperplasia (BPH) with acontractile detrusor (ACD).Method:Comparative studies were performed in 12 cases of TURP or in combination with TUIBN (transurethral incision of bladder neck) with acontractile detrusor and bladder outlet obstruction (BOO) (Group A) and 24 TURP with normal function or hyperfunction of detrusor (Group B).Results:After surgical treatment 7～30 days,Q max and IPSS improved in group A (P< 0.05 amd P< 0.001 ),Q max is 11.05 ± 0.85 ml/s,IPSS is 12.58 ± 0.70 .But the postoperative effect of group B is better than that of group A (P< 0.001 ).After surgical treatment 3, 6 months,IPSS and Q max changed slightly in the two groups,residual urine is normal.After surgical treatment 3 months,pressure flow studies were performed in 5 patients of group A,the detrusor function have no improvement.Conclusion:ACD with BOO in BPH patients are also fit for TUR treatment.