良性前列腺增生患者经微创手术治疗后出现尿道狭窄的高危因素调查

Investigation of High Risk Factors for Urethral Stricture in Patients with Benign Prostatic Hyperplasia Treated by Minimally Invasive Surgery

目的:探讨良性前列腺增生(BPH)患者经微创手术治疗后尿道狭窄的高危因素。方法:回顾性分析2021年8月—2023年8月首钢水钢医院收治的85例BPH患者的临床资料,所有患者均行经尿道前列腺电切术(TURP)治疗,依据术后是否出现尿道狭窄分为尿道狭窄组(n=19)、非尿道狭窄组(n=66),收集两组年龄、病程、手术时间、术后留置导尿管时间、合并高血压、合并糖尿病、伴尿道感染、前列腺体积、术中出血量、术后膀胱冲洗时间、持续牵引气囊导尿管时间、术中行尿道扩张等多方面基础资料,先行单因素分析,再行logistic回归分析,获得影响BPH患者微创手术后尿道狭窄的高危因素。结果:85例患者共出现19例尿道狭窄,发生率为22.35%(19/85)。尿道狭窄组手术时间≥70 min、术后留置尿管时间≥7 d、合并糖尿病、伴尿道感染、前列腺体积≥70 mL、持续牵引气囊导尿管时间≥15 h、术中行尿道扩张患者占比高于非尿道狭窄组,差异均有统计学意义(P<0.05)。多因素分析显示,手术时间≥70 min、术后留置导尿管时间≥7 d、合并糖尿病、伴尿道感染、前列腺体积≥70 mL、持续牵引气囊导尿管时间≥15 h、术中行尿道扩张为影响BPH患者微创手术后尿道狭窄的高危因素(P<0.05)。结论:BPH患者微创术后尿道狭窄发生与手术时间、术后留置导尿管时间、合并糖尿病、伴尿道感染、前列腺体积、持续牵引气囊导尿管时间、术中行尿道扩张关系密切,还需做好干预措施,降低尿道狭窄风险。

Objective:To investigate the high risk factors of urethral stenosis in patients with benign prostatic hyperplasia(BPH)treated by minimally invasive surgery.Method:The clinical data of 85 BPH patients admitted to Shougang Shuigang Hospital from August 2021 to August 2023 were retrospectively analyzed.All patients underwent transurethral resection of prostate(TURP)and they were divided into urethral stenosis group(n=19)and non-urethral stenosis group(n=66)according to whether urethral stenosis occurred after surgery.Various basic data including age,disease course,operation time,postoperative indentured catheter time,combined with hypertension,combined with diabetes,combined with urinary tract infection,prostate volume,intraoperative blood loss,postoperative bladder irrigation time,continuous traction balloon catheter time,intraoperative urethral dilation were collected in the two groups.Univariate analysis was performed first,followed by logistic regression analysis.To obtain the risk factors affecting urethral stricture after minimally invasive surgery in BPH patients.Result:There were 19 cases of urethral stricture in 85 patients,the incidence was 22.35%(19/85).The proportion of patients with operation time≥70 min,postoperative indentured catheter time≥7 d,combined with diabetes,combined with urinary tract infection,prostate volume≥70 mL,continuous traction balloon catheter time≥15 h,intraoperative urethral dilation in urethral stricture group were higher than those in non-urethral stricture group,the differences were statistically significant(P<0.05).Multifactor analysis showed that operation time≥70 min,postoperative indentured catheter time≥7 d,combined with diabetes,combined with urinary tract infection,prostate volume≥70 mL,continuous tractive balloon catheter time≥15 h,and intraoperative urethral dilation were the risk factors for urethral stenosis after minimally invasive surgery in BPH patients(P<0.05).Conclusion:The occurrence of urethral stenosis after minimally invasive surgery in BPH patients is closely related to the operation time,postoperative indentured catheter time,combined with diabetes,combined with urinary tract infection,prostate volume,continuous traction balloon catheter time,and intraoperative urethral dilation.Intervention measures should be taken to reduce the risk of urethral stenosis.