45例膀胱颈部梗阻腔内手术长期疗效的评价

Endoscopic surgery for bladder neck obstruction (Report of 45 cases)

目的 :评价经尿道膀胱颈部电切术 (TURN)治疗膀胱颈部梗阻 (BNO)的长期疗效。方法 :采用TURN治疗BNO 4 5例。结果 :4 5例平均随访 6 0个月。 1次手术治愈 34例 ;复发 4例 ,经再次或 3次手术治愈 ;无效 7例。总有效率 84 .0 % ,复发率 10 .5 %。结论 :TURN治疗BNO远期疗效比较满意。伴慢性前列腺炎及女性BNO手术应慎重。

Purpose:To evaluate transurethral resection of bladder neck (TURN) for bladder neck obstruction (BNO).Methods:Forty five patients suffering from BNO were treated by TURN.Results:All patients have been followed up for twelve to ninty six months with a mean of sixty months. The total success rate in this series was 84.0 %. BNO recurrence was observed in four patients and the recurrence rate was 10.5 percent. All of the recurrent patients were cured by 2 to 3 times of TURN. The causes of seven failures were due to neurogenic bladder, detrusor extra sphincter dyssynergy, BNO with chronic prostatitis (CP) or BNO with chronic cystitis in female patients.Conclusions:Endoscopic surgery is a safe and efficient treatment for BNO. The operation must be reckoned with in BNO with CP or in female BNO patient. Some patients need adjunct hormone supplement therpy and long-period urethral dilatation for preventing recurrence.