经尿道前列腺电切术后膀胱颈挛缩多因素分析

Multifactor Analysis of Bladder Neck Contractures after Transurethral Resection of Prostate

目的 :对经尿道前列腺电切术 (TURP)后膀胱颈挛缩 (BNC)发生的各种可能因素进行分析 ,探讨减少该并发症的途径。 方法 :对 10 17例行TURP患者中发生BNC的 2 4例进行统计学分析 ,在手术方法、前列腺电切重量、单位时间前列腺组织电切重量、置管时间、高频发生器类型及有无糖尿病、尿潴留及前列腺炎等方面进行比较 ,了解其可能发生的因素。 结果 :TURP术后BNC发生率明显高于开放手术病例 ,小前列腺、单位电切时间长、高频发生器功率大及术前前列腺炎患者易发生BNC(P <0 .0 5 ) ,而术前尿潴留、糖尿病及术后置管时间对BNC发生无明显影响 (P >0 .0 5 )。 结论 :小前列腺、前列腺炎及电流损伤是发生BNC的重要因素 ,患者的选择及熟练精确的电切技术可减少BNC的发生。

Objective: To analyse different factors related to the occurrence of bladder neck contracture (BNC) and to find possible ways of reducing this complication. Methods: All putative factors and the numbers of BNC cases were studied with statistical analyses in 1 017 cases that had undergone transurethral resection of the prostate (TURP). Results: The morbidity of BNC after TURP was significantly higher than that of open operations. Small size of the prostate, longer time of operation, higher power in resection and prostatitis were factors of BNC. Conclusion: Properties of the prostate and electrical current injuries of resection are the primary factors of BNC. The selection of patients and techniques of TURP are most important in decreasing the morbidity of BNC.