摘要
目的探讨老年前列腺增生患者尿道断裂的合理治疗方法。方法2003年9月至2011年6月，治疗老年前列腺增生患者尿道断裂患者11例。球部尿道断裂4例患者先行尿道吻合术，其中2例术后2周内行经尿道前列腺电切术；另外2例3个月后分别行前列腺电切术和开放前列腺摘除术。后尿道断裂患者共7例，1例行尿道会师术加开放前列腺摘除术；1例先行尿道会师术后再行经尿道前列腺电切术；3例膀胱造瘘术患者延期行后尿道吻合术者，2例行经尿道前列腺电切术，另1例行开放性前列腺摘除术；2例单纯行膀胱造瘘术。结果本组患者随访4～60个月。球部尿道断裂患者术后均排尿通畅，球部尿道吻合术后及早行前列腺切除的2例（8周）治疗周期明显短于另外2例（25周）。后尿道断裂行尿道修复手术的患者治疗结束后排尿通畅者4例；1例病人自述排尿尚满意，但需间歇尿道扩张术；另外2例行耻骨上膀胱造瘘术。后尿道断裂患者治疗周期平均为19．6周（4-50周），排除2例造瘘者，平均治疗周期25．4周（7-50周）；行尿道会师术患者平均治疗周期为10．5周，明显短于先膀胱造瘘再行后尿道吻合术3例患者（35．3周）。结论前、后尿道断裂，在行尿道修复术后及早解除前列腺梗阻是恢复尿路通畅的关键，可缩短治疗周期。
Objective To explore the reasonable treatment of urethral disruption for the elderly patients with benign prostatic hyperplasia. Methods From September of 2003 to June of2011, 11 elderly BPH patients with urethral disruption received surgery treatment. Four patients with anterior urethral disruption were treated with antecedent urethral anastomosis, and 2 cases of them were continually treated with transurethral resection of prostate during of postoperative 2 weeks,.the other 2 patients were treated respectively with transurethral resection of the prostate and open prostatectomy after 3 months. One patient with posterior urethral disruption was treated with urethral realignment and open prostatectomy. One case after urethral realignment with transurethral resection of prostate; For 3 bladder ostomy patients, 2 of them were treated with transurethral resection of the prostate after delay posterior urethral anastomosis, 1 cases with open prostatectomy; 2 cases with bladder fistulization. Results The patients were followed up for 4-60 months. Anterior urethral disruption patients had good voiding, treatment period of urethral anastomosis after early prostatec- tomy for 2 patients （8 weeks） was significantly shorter than that of other 2 patients （ 25 weeks）. 4 cases of posterior urethral disruption had good voiding after urethral repair operation; 1 patient felt voiding satisfactory, but required intermittent urethral dilation; except 2 cases suprapubic cystostomy. Average treatment period of posterior urethral disruption in a patient was 19.6 weeks （4 -50 weeks）, average treatment cycle was 25.4 weeks （7 - 50 weeks） except of 2 cases of fistula,; average treatment period of line urethral realignment （10.5 weeks）, was significantly shorter than that of the first bladder fistulization and posterior urethral anastomosis （35.3 week ）. Conclusion For treatment of BPH patients with anterior, posterior urethral disruption, urethral repair and timely relieving prostatic obstruction may be keys to restore urinary tract unobstructed, and shorten the treatment period.
出处
《中国男科学杂志》
CAS
CSCD
北大核心
2012年第8期19-21,28,共4页
Chinese Journal of Andrology
