针状电极三点内切开治疗前列腺电切术后膀胱颈挛缩

Needle Electrode Three-point Endo-incision for Bladder Neck Contracture After Transurethral Resection of Prostate

目的探讨针状电极三点内切开治疗经尿道前列腺电切术(transurethral resection of prostate,TURP)后膀胱颈挛缩(bladder neck contracture,BNC)的效果。方法 2015年2月～2018年1月我们采用针状电极三点内切开治疗经尿道前列腺电切术后BNC 25例,应用针状电极在BNC的5、7、12点位从颈口至精阜上缘完全切开至脂肪层。结果 25例顺利完成手术,手术时间30～95 min,(48.0±15.1)min;术后膀胱冲洗时间10～24 h,(15.1±4.8)h;术后拔除尿管时间3～7 d,平均5 d;无尿外渗、尿失禁等。术后1个月IPSS由术前(25.7±3.7)分降至术后(5.1±1.8)分(t=27.862,P=0.000);Qmax由术前(7.4±2.8)ml/s提高至术后(22.6±5.0)ml/s(t=-15.912,P=0.000)。20例随访3～12个月,平均9个月,无尿失禁、逆行射精、BNC发生。结论针状电极三点内切开治疗TURP术后BNC安全、精准、可靠,并发症少,是一种行之有效的方法。

Objective To evaluate the efficacy of needle electrode three-point endo-ineision for bladder neck eontraeture after transurethral resection of prostate, Methods From February 2015 to January 2018, we utilized needle electrode to divide the bladder neck at the 5, 7, and 12 o＇ clock positions until exposure to the fat layer, extending from the bladder neck to the verumontanum, in 25 cases. Results All the 25 cases of bladder neck eontraeture were treated successfully. The operation time was （48.0±15.1） rain （range, 30-95 min）. The postoperative bladder washing time was （15.1±4.8） h （range,10-24 h）. The urethral catheter was withdrawn in 3 -7 d （mean, 5 d）. No urinary infiltration or incontinence occurred. Re-examinations were carried out in one month after the surgery, which showed significantly decreased IPSS fronl （25.7 ± 3.7） points to （5. 1 ± 1.8 ） points （ t = 27. 862, P=0.000） and increased Qmax from （7.4±2.8） ml/s to （22.6±5.0） ml/s （t= -15.912, P=0.000）. A total of 20 cases were followed up for 3 -12 months （mean, 9 months）. No patients had urinary incontinence, retrograde ejaculation or bladder neck eontraeture. Conclusion Needle electrode three-point endo-ineision has less complications, being a safe, effective, and reliable treatment for bladder neck eontraeture after transurethral resection of prostate.