经尿道2μm激光前列腺汽化切除术后再入院原因及对策

Causes and Managements of Readmission After Transurethral Vaporesection of Prostates by 2μm Continuous Wave Laser

目的探讨经尿道Revo Lix 2μm激光前列腺汽化切除术后需再次入院治疗的原因。方法回顾性分析2011年6月至2014年6月本院收治的经尿道2μm激光前列腺汽化切除术后再入院患者的临床资料。结果 317例接受经尿道2μm激光前列腺汽化切除术患者再次入院16例。再入院原因按发生例数依次排列如下:血尿8例,膀胱颈挛缩3例,前列腺癌2例,前尿道狭窄、泌尿系感染和急性附睾炎各1例。给予相应处理后均顺利出院。结论继发出血及膀胱颈挛缩是经2μm激光前列腺汽化切除术后再入院的主要原因,需注意围术期管理及术后随访,根据病情变化及时给予相应处理。

Objective To analyze the causes and managents of readmission after transurethral vaporesection for benign prostatic hyperplasia by 2μm continuous wave laser. Methods A retrospective study was conducted to summarize the cases who were readmitted after transurethral vaporesection for BPH by 2μm continuous wave laser. Results 317 patients received this operation from June 2011 to June 2014 in our hospital. Among them, 16 patients experienced readmission after mean interval of 1.8 months with an incidence rate of 5.05%. 8 cases that had experienced bleeding and acute retention underwent transurethral bladder washing and coagulating. Bladder neck contracture was found in 3 cases and received transurethral resection of scar by 2μm continuous wave laser, followed with regular urethral dilatation. Prostate cancer was detected in 2 cases, who received medical castration finally. 1 cases developed anterior urethral stricture and received internal urethrotomy by 2μm continuous wave laser and followed with regular urethral dilatation. 2 case received antibiotic therapy for urological tract infection or unilateral acute epididymitis. Conclusions Bleeding and bladder neck contracture were main causes for readmission after this operation. Correct preoperative diagnosis, rational surgical type and adequate intraoperative and postoperative management are keys to preventing readmission.