经尿道前列腺汽化电切术后尿道狭窄的防治  

Treatment and prevention of urethral stricture complicated by transurethral vapo -resection of prostate

作　　者：李义[1] 叶敏[2] 王加强[1] 王孟春[1] 王伟明[2] 

机构地区：[1]吉林省人民医院泌尿外科,长春130021 [2]上海第二医科大学附属新华医院泌尿外科

出　　处：《中华泌尿外科杂志》2005年第2期121-124,共4页Chinese Journal of Urology

摘　　要：目的　探讨经尿道前列腺汽化电切 (TVP)术后尿道狭窄的防治。　方法　统计分析TVP病例中尿道狭窄的发生率和防治方法。30 12例患者中 ,术后 4周～ 2 2个月发生尿道狭窄 95例 ,占 3.15 %。年龄 5 5～ 85岁 ,平均 6 8.7岁。前尿道狭窄 4 7例 (49.5 % ) ,后尿道狭窄 31例 (32 .6 % ) ,膀胱颈挛缩或闭锁 17例 (17.9% )。　结果　 95例患者术后随访 4～ 36个月 ,平均 14个月。行单纯尿道扩张术 6 5例 ,治愈 5 9例 (90 .8% ) ,失败 6例改尿道内切开术 ;尿道内切开加尿道扩张术 19例 ,治愈 13例 (6 8.4 % ) ,失败 6例改尿道成形术 ;膀胱颈部闭锁或挛缩者 17例 ,作膀胱颈部凿通和电切术 ,治愈 15例 (88.2 % ) ,失败 2例。　结论　尿道狭窄为TVP术后常见并发症 ,术后定期密切随访和早期治疗是治愈的关键。Objective To evaluate the treatment and p re vention of urethral stricture complicated by transurethral vapo-resection of pr ostate (TVP). Methods Retrospective analysis was conduct ed by reviewing medical records and following up the patients under study.Among 3012 patients with benign prostatic hyperplasia treated with TVP, urethral stric ture occurred 4 weeks to 22 months following surgery in 95 cases (3.15 %), inclu ding anterior in 47 (49.5%),posterior in 31 (32.6 %) and bladder neck contractur e or occlusion in 17 (17.9%).Their mean age was 68.7 years (range, 55 to 85 year s). Results The 95 patients were followed up for 4～36 m o nths (mean,14 months).Of them,65 cases underwent conventional dilation, in them 59 (90.8%) were cured and 6 had failure,then turning to internal urethrotomy;19 cases underwent internal urethrotomy plus dilation,in them,13 (68.4%) were cured and 6 had failure,then turning to urethroplasty;17 cases of bladder neck contra cture or occlusion underwent transurethral resection of bladder neck scar tissue ,with a cure rate of 88.2% (15 were cured and 2 experienced failure). Conclusions Urethral stricture is a common complication after TVP. The key points of managing the strictures are patients’ alert,close follow-up and early effective treatment.

关 键 词：术后 后尿道狭窄 治愈 TVP 经尿道前列腺汽化电切术 膀胱颈部 尿道扩张术 结论 目的 统计分析 

分 类 号：R699[医药卫生—泌尿科学]