腹腔镜膀胱颈Y-V成形术治疗前列腺增生术后膀胱颈挛缩疗效分析

Laparoscopic bladder neck Y-V plasty for bladder neck contracture induced by operation of benign prostatic hyperplasia

目的观察腹腔镜膀胱颈Y-V成形术治疗前列腺增生术后膀胱颈挛缩的临床效果。方法回顾性分析2018年1月~2019年7月因前列腺增生术后发生膀胱颈挛缩而行腹腔镜膀胱颈Y-V成形术12例患者的临床资料,通过患者的最大尿流率、残余尿量、IPSS评分及有无复发判断手术效果。结果 12例患者均一次性手术成功,手术时间100~129min,中位手术时间120min,出血量80~120ml,中位出血量95ml;术后住院时间4~5d,耻骨后引流管拔除时间均2d,尿管拔除时间术后2周,术后6个月与术前的最大尿流率、残余尿量、IPSS评分比较,差异有显著性(P<0.05),随访时间6~24个月,无挛缩复发及尿失禁患者出现。结论腹腔镜膀胱颈Y-V成形术治疗前列腺增生术后膀胱颈挛缩具有创伤小、疗效稳定等优点,是一种行之有效的手术方式。

Objective To explore the clinical effect of laparoscopic bladder neck Y-V plasty in the treatment of bladder neck contracture after transurethral resection of the prostate.Methods Respectively analyze the clinical data of 12 patients undergoing laparoscopic bladder neck YV angioplasty due to bladder neck contracture from January 2018 to July 2019.The maximum urine flow rate,residual urine volume,and the IPSS score and the presence or absence of recurrence are used to determine the surgical effect.Results All the 12 patients had a one-time successful operation.The operation time was 100~129 minutes,the median operation time was 120 minutes,the bleeding volume was 80~120 ml,and the median bleeding volume was 95 ml.At 2 days,the time for urinary catheter removal was 2 weeks after surgery,and there was a statistically significant difference between the maximum urinary flow rate,residual urine volume,and IPSS score at 6 months after surgery(P<0.05).The follow-up time was 6 to 24 Months,patients without recurrence of contractures and urinary incontinence appeared.Conclusion Laparoscopic bladder neck Y-V plasty has the advantages of less trauma and stable curative effect,which is an effective surgical method for those who suffer from bladder neck contracture after electroprostatectomy.