经尿道前列腺电切术后排尿困难的原因、治疗和预防  

Causes,Treatments and Prevention of Dysuria after Transurethral Resection of Prostate(TURP)

作　　者：续奇志[1] 邵晋凯[1] 蔚锐传[1] 吕永安[1] 

机构地区：[1]山西省人民医院泌尿外科,太原030012

出　　处：《中国微创外科杂志》2009年第7期630-631,634,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨经尿道前列腺电切(transurethral resection of prostate,TURP)术后排尿困难的原因、治疗和预防。方法回顾分析2004年8月～2008年9月49例TURP术后出现排尿困难的临床资料。结果6例因为拔除尿管后膀胱颈和尿道水肿再次留置较细硅胶尿管,9例术后前列腺迟发出血未及时就诊予以膀胱冲洗后留置尿管,20例尿道外口狭窄予以尿道扩张或尿道外口切开,5例尿道其他部位狭窄予以尿道扩张,4例膀胱颈挛缩予以冷刀切开或扩尿道治疗,5例前列腺术后腺体残留4例予以再次电切,1例因结肠癌晚期长期卧床行膀胱造瘘术。结论TURP术后并发排尿困难,以尿道外口狭窄多见,尿道扩张是常用而有效的首选治疗方法。Objective To investigate the causes, treatments, and prevention of dysuria after transurethral resection of prostate （TURP）. Methods The clinical data of 49 cases of dysuria post-TURP that were treated in our hospital from July 2004 to September 2008 were analyzed retrospectively. Results Among the cases, 6 patients received silica eatheterization again because of edema of the bladder neck and urethra; 9 underwent catheterization after bladder flush for delayed prostate bleeding; 20 underwent urethral dilatation or meatotomy due to meatal stenosis, 5 received urethral dilatation for urethral stricture; urethral dilatation or direct vision internal urethrotomy were performed on 4 cases who had bladder neck fracture; TURP was carried out for a second time in 4 cases because of glandular residual; suprapubic eystostomy was made in 1 case of colonal carcinoma for long-term bed rest. All cases were cured after the treatment. Conclusions Meatal stenosis is the most common cause of dysuria post-TURP. Urethral dilatation is the first choice for the disease.

关 键 词：经尿道前列腺电切术 排尿困难 前列腺增生症 

分 类 号：R699[医药卫生—泌尿科学]