缝扎膀胱下动脉保留后尿道前列腺切除术

Prostatectomy by Transfixing Inferior Vesical Artery and Reserving Posterior Urethra

目的 探讨开放性前列腺切除术的新术式。方法 采用对比研究方法 ,对良性前列腺增生 (BPH)患者 71例 ,随机分为三组。⑴治疗组 (采用缝扎膀胱下动脉保留后尿道前列腺切除术—改良Madigan术 ) 2 1例 ;⑵对照Ⅰ组 (采用Millin术 ) 18例 ;⑶对照Ⅱ组(采用经耻骨上膀胱前列腺切除术 ) 3 2例。观察其治疗效果。结果 全部病例 ,术后病理报告均为良性前列腺增生 (BPH)。治疗组无论在术中尿道损伤 ,出血量 ,术后膀胱冲洗天数 ,近期尿失禁 ,继发出血 ,尿路感染 ,膀胱痉孪 ,尿道狭窄 ,以及住院天数等方面 ,均优于对照组。结论 缝扎膀胱下动脉保留后尿道前列腺切除术具有术式简单 ,操作较容易 ,住院时间短 ,医疗费用少等优点 ,易于推广 。

Objective To study a new method of opening prostatectomy.Methods 71 cases of benign prostatic hyperplasia (BPH) patients were divided into three group at random;treating group:prostatectomy by transfixing inferior vesical artery and reserving posterior urethra(n=21),control group Ⅰ:Millin operation(n=18) and control group Ⅱ:cystoprostatectomy through superior pectineus(n=32),the clinical effect was studied and observated.Results All 71 cases of patients were BPH according to pathology reports.Treating group had lower incidence than that of control group in injury of urethra,bleeding after operation,the times of irrigation of urinary bladder,urinary incontinence in the near future,secondary bleeding,urinary tract infection,bladder spasm,urethral stricture,and so on.Conclusions Prostatectomy by transfixing inferior vesical artery and reserving posterior urethra has many virtues such as simple,soon to discharge,cheapness of medical cost,and easy to spread.