等离子电切镜治疗女性膀胱颈梗阻

Bipolar Plasma for the Treatment of Female Bladder Neck Obstruction

目的总结等离子电切镜治疗机械性女性膀胱颈梗阻(female bladder neck obstruction,FBNO)的体会。方法2012年2月~2018年5月,对19例FBNO行等离子电切镜治疗,术前国际前列腺症状评分(IPSS)27.9±4.5,生活质量评分(QOL)5.2±0.4,最大尿流率(Qmax)(7.1±4.3)ml/s,用Olympus 26Fr等离子双极电切镜针状电极切断膀胱颈部狭窄环3点和9点处,对合并炎性息肉14例、腺性膀胱炎8例同时行电切或电灼治疗,对膀胱颈部后唇明显隆起4例行隆起处切除。结果手术时间(23.0±2.0)min,19例术后随访(32.8±17.1)月,IPSS 4.7±3.2,QOL 1.1±0.8,Qmax(24.2±5.4)ml/s,均较术前明显改善(P均=0.000)。无手术并发症。结论等离子电切镜针状电极切断膀胱颈部狭窄环的3点和9点处并同时处理相关病变治疗FBNO简单易学,安全,有效。

Objective To evaluate the efficacy and safety of bipolar plasma for the treatment of female bladder neck obstruction(FBNO).Methods A total of 19 cases were enrolled in this study.The preoperative international prostate symptom score(IPSS),quality of life(QOL),and Qmax were 27.9±4.5,5.2±0.4 and(7.1±4.3)ml/s,respectively.Incisions were performed in 3 and 9 o’clock of the bladder neck stricture by using bipolar plasma(26Fr,Olympus).Resection or coagulation was performed when inflammatory polyps(14 cases)or cystitis glandularis(8 cases)were observed during operation.Transurethral resection of bladder neck was performed in 4 cases.Results The mean operative time was(23.0±2.0)min and the mean follow-up time was(32.8±17.1)months.The postoperative IPSS,QOL and Qmax were 4.7±3.2,1.1±0.8,and(24.2±5.4)ml/s(all P=0.000),respectively.No severe perioperative complications were observed.Conclusion Incision in 3 and 9 o’clock of the bladder neck stricture by using bipolar plasma is effective and safe for the treatment of FBNO.