经尿道前列腺等离子双极电切术后发生尿道狭窄及膀胱颈挛缩的危险因素

Risk Factors for Urethral Stricture and/or Bladder Neck Contracture After Transurethral Plasmakinetic Prostatectomy for Benign Prostatic Hyperplasia

目的 探讨经尿道前列腺等离子双极电切(TUPKP)术后发生尿道狭窄和/或膀胱颈挛缩(BNC)的危险因素.方法 收集2016年1月—2018年12月泌尿外科收治的716例TUPKP患者资料,根据随访有无尿道狭窄和/或BNC,分为对照组与并发症组,比较两组相关指标及分析影响因素.结果 术后随访时间超过1年患者523例,67例(12.81%)术后出现尿道狭窄和/或BNC,出现尿道狭窄和/或BNC时间为术后(5±3)个月.回归分析得出合并慢性前列腺炎(P<0.001)、前列腺大体积(P=0.008)和多次膀胱引流(P=0.016)是术后发生尿道狭窄和/或BNC的危险因素.结论 影响尿道狭窄/BNC的因素主要包括大体积前列腺增生、合并慢性前列腺炎及反复膀胱引流.在临床工作中需要针对以上因素及早进行干预.

Objective To identify risk factors for urethral stricture and/or bladder neck contracture(BNC)after transurethral plasmakinetic prostatectomy(TUPKP)for benign prostatic hyperplasia.Methods 716 patients undergoing TUPKP of the prostate were collected from Jan 2016 to Dec 2018.According to urethral stricture and/or BNC,the patients were divided into control group and complications group,and the related indexes and influencing factors were compared between the two groups.Results 523 patients were followed up for more than 1 year.Urethral stricture and/or BNC in the postoperative period were diagnosed in 67(12.81%)patients and observed in average(5±3)months after TUPKP.Regression analysis established the significance of the influence of risk factors on the development of urethra and bladder neck:presence of prostatitis(P<0.001),large prostate volume(P=0.008),and multiple bladder drainage(P=0.016).Conclusion The factors affecting urethral stricture/BNC mainly include massive prostatic hyperplasia,complicated with chronic prostatitis and repeated bladder drainage.Early intervention is required in clinical work for the above factors.