良性前列腺增生开放手术后排尿困难的原因及处理

Causes and management of difficulty of urination after suprapubic prostatectomy

目的 探讨良性前列腺增生开放手术后排尿困难的发生原因及处理方法。 方法 分析总结 5 6例良性前列腺增生开放手术后排尿困难患者的原因及处理经验。排尿困难的原因有膀胱颈口狭窄或孪缩、尿道狭窄、腺体残留或复发、膀胱逼尿肌乏力或神经源性膀胱机能障碍和其他泌尿系疾患。 结果 手术治疗 4 8例 ,成功 4 5例 (94 % ) ,术后随访 2～ 84个月 ,平均 38个月 ,均排尿通畅。 3例失败 ,长期留置耻骨上膀胱造瘘。 结论 正确的术前诊断。

Objective To explore the causes and treatment of difficulty of urination after suprapubic prostatectomy. Methods 56 cases with difficulty of urination after suprapubic prostatectomy were reviewed.The causes of difficulty of urination were bladder outlet stricture,urethral stricture,relapse of BPH and other nonsurgical causes. Results 48 cases were surgically managed,and the success rate was 94%.The follow up time was 2～84 months with a mean of 38 months,all of them urinate normally except in 3 suprapubic cystostomy has been mandatory. Conclusions Correct presurgical diagnosis,adequate surgical treatment and postsurgical management are key points in preventing postsurgical difficulty of urination.