摘要
目的分析并探讨经尿道前列腺电切术（TURP）术后尿道狭窄的原因，避免其发生。方法回顾性分析我院1999年1月至2010年1月收治的23例前列腺电切术后尿道狭窄患者，年龄57—78岁，平均67．8岁；狭窄段尿道长度为1．6—3．5cm（平均2-3cm）；最大尿流率为4—14ml／s，平均7．5ml／s；术后出现狭窄的时间为1个月～17年，平均25个月。其中前尿道狭窄6例，后尿道狭窄15例，膀胱颈口处狭窄2例。对于明确的尿道狭窄患者，针对不同情况分别给予尿道扩张、尿道内冷刀切开、残留前列腺组织切除或瘢痕切除处理。结果随访3个月-6个月，23例患者中6例前尿道狭窄经定期尿道扩张后症状消失，疗效满意。后尿道狭窄的15例患者，2例采用定期尿道扩张的方法治愈，3例行残留腺体切除后症状逐渐缓解，另外1例因后尿道瘢痕较多，于尿道内行冷刀切开后复发，其余后尿道狭窄患者疗效满意。膀胱颈口处狭窄的2例患者，行膀胱颈口冷刀切开及瘢痕切除后治愈。术后23例患者最大尿流率19—29ml／s，平均24．4ml／s。结论尿道狭窄是TURP术后常见的并发症，其发生与尿路感染、操作损伤、术后留置尿管过粗、置管时间过长、腺体残留等因素密切相关。
Objective To investigate the cause of urethral stricture after transurethral resection of the prostate（TURP） for avoiding its occurrence. Methods A retrospective study of 23 patients with urethral stricture developed after TURP from Jan 1999 to Jan 2010 were analyzed. Mean age was 67.8 years （57-58）. The length of urethral stricture was 1.6-3.5 cm （average 2.3 cm）. The maximum urine flow rate is 4-14 ml/s（average 7.5 ml/s）. The mean duration of urethral stricture apperance after operation was 25 months（range from 1 month to 17 years）. Of these 23 patients, 6 were anterior urethra stricture, 15 were posterior stricture, 2 were bladder neck stricture. According to different situations, patients underwent urethral dilatation, internal urethrotomy, residue prostate tissue excision or scar excision. Results Follow-up 3 months to 6 months, 6 anterior urethral stricture patients were cured after regularly urethral expansion, and the results were satisfactory; 15 posterior urethral stricture pa- tients, 2 were cured by regular urethral expansion, 3 patients＇ symptoms gradually alleviate after excision of residue glands, another 1 patient recurred after internal urethrotomy because of posterior urethral scar, the resid- uas patients with posterior urethral stricture were satisfactory with postoperative management. Two bladder neck stricture patients were cured by resection of internal bladder neck and scar. Of these 23 patients,the maximum urine flow rate post operation was 19-29 ml/s （average 24.4 ml/s）. Conclusions The common postoperative complication of TURP is urethral stricture, the occurrence of this complication were closely related to urinary in- fections,operative injures,oversize urethral catheter,overlong of drainage time of treasurethral catheter, and residual prostate.
出处
《中华腔镜泌尿外科杂志（电子版）》
2012年第1期52-54,共3页
Chinese Journal of Endourology(Electronic Edition)
