腹腔镜膀胱颈Y-V成形术和经尿道膀胱颈电切术治疗前列腺增生术后膀胱颈挛缩疗效分析

Efficacy analysis of laparoscopic Y-V cystoplasty and electroresection in the treatment of bladder neck contracture after benign prostatic hyperplasia

目的观察治疗良性前列腺增生术后膀胱颈挛缩(BNC)的两种手术方式的临床效果。方法收集2014年1月~2020年6月因良性前列腺增生术后膀胱颈挛缩行手术治疗的48例患者的临床资料,根据手术方式的不同将患者分为腹腔镜组和电切组,记录围手术期参数,包括术前一般资料、术中及术后相关数据,并于术后3个月记录Qmax、IPSS评分、残余尿量及BNC复发率,分析比较两种手术效果。结果两组患者术前一般资料(年龄、病程长短、Qmax、残余尿量、IPSS)比较,差异无统计学意义(P>0.05);腹腔镜组的手术时间、失血量明显多于电切组(P<0.05),但两组患者术后住院时间、尿管留置时间比较,差异无统计学意义(P>0.05);与术前相比,两组术后3个月Qmax、残余尿量、IPSS评分均有显著改善(P<0.05),但两组患者术后3个月的相关指标比较,差异无统计学意义(P>0.05)。结论两种术式均可明显改善下尿路症状,但腹腔镜膀胱颈Y-V成形术相对较低的术后BNC复发率,使其在治疗BNC方面具有独特的价值。

Objective To investigate the clinical effects of two surgical methods for the treatment of bladder neck contracture(BNC)after surgery for benign prostatic hyperplasia(BPH).Methods From January 2014 to June 2020,the clinical data of 48 patients with bladder neck contracture after benign prostatic hyperplasia surgery admitted to the hospital were collected.According to the different surgical methods,the patients were divided into laparoscopy group and electroresection group.Perioperative parameters,including preoperative general data,intraoperative and postoperative data,as well as Qmax,International Prostate Symptom Score(IPSS),residual urine volume(RUV)and BNC recurrence rate three months after operation were recorded.The safety and effect of the operation were evaluated comprehensively.Results There was no significant difference in preoperative general data(age,course of disease,Qmax,RUV,IPSS)between the two groups.The operation time and blood loss in the laparoscopy group were significantly greater than those in the electroresection group,but there was no significant difference in postoperative hospital stay and catheter indwelling time between the two groups.Compared with those before operation,the scores of Qmax,RUV and IPSS in the two groups were significantly improved three months after operation(P<0.05),but there was no significant difference in related indexes between the two groups three months after operation(P<0.05).Conclusion Both the two types of surgical procedures can significantly improve the symptoms of lower urinary tract,but laparoscopic Y-V cystoplasty has a relatively low recurrence rate of BNC after operation,which makes it have unique value in the treatment of BNC.