经尿道前列腺电切术术后排尿困难原因分析及治疗探讨

Cause Analysis and Treatment of Urination Difficulty after Transurethral Resection of Prostate

目的:探讨经尿道前列腺电切术术后排尿困难的原因及防治对策。方法:回顾性分析25例经尿道前列腺电切术排尿困难患者的临床资料,观察其发生原因和治疗结果,探讨避免和减少排尿困难措施。结果:25例排尿困难原因分别为:尿道狭窄17例(68.00%),膀胱逼尿肌无力或神经源性膀胱尿道功能障碍3例(12.00%),腺体残留2例(8.00%),膀胱内血块、组织碎片和结石堵塞尿道2例(8.00%),膀胱颈挛缩1例(4.00%)。手术治疗19例(76.00%),随访(8.33±3.09)个月,排尿困难的症状均消失或明显改善,最大尿流率为(19.98±7.34)ml/s,残余尿量为(39.87±18.45)ml;非手术药物治疗者6例(24.00%),全部为神经源性膀胱尿道功能障碍者,治疗3个月2例排尿困难缓解,其余4例仍存在排尿困难行耻骨上膀胱穿刺造瘘术。结论:导致前列腺电切术术后排尿困难原因多种多样,应根据不同原因实施相应治疗,同时通过实施针对性预防措施预防排尿困难的发生。

Objective： To investigate the causes and preventive measures of postoperative urination difficulty after transurethral resection of prostate.Method： The clinical data of 25 patients with transurethral resection of prostate were retrospectively analyzed, and the causes and treatment of patients were observed.Result： 25 cases of difficulty of urination were reasons were： urethral stricture in 17 cases （68.00%）, bladder detrusor muscle weakness or neuregenic bladder urethra dysfunction in 3 cases（12.00%）, glandular residue in 2 cases（8.00%）, bladder clot and tissue debris and calculus obstruction of the urethra in 2 cases（8.00%）, bladder neck contracture in 1 case（4.00%）.Surglcal treatment of 19 cases（76.00%）, follow-up （8.33 ± 3.09） months, the symptoms were disappeared or significantly improved, the maximum urinary flow rate was （19.98 ± 7.34）ml/s, residual urine volume was （39.87 ± 18.45）ml.6 cases（24.00%） of non surgical treatment, 2 cases of neuregenic bladder urethral dysfunction, and the remaining 4 cases were still difficult to treat.Conclusion： The reasons for the difficulty of urination after transurethral resection of prostate are complex, according to different reasons, the effect of the corresponding treatmant is satisfactory, and the implementation of targeted prevention measures to reduce the occurrence of difficulty of arination.