前列腺囊肿微创治疗的选择(附7例报告)  

Minimally Invasive Treatment of Prostatic Utricle Cyst(Report of 7 Cases)

作　　者：高健刚[1] 朱磊一[1] 侯四川[1] 孙小庆[1] 白鑫[1] 祝海[1] 张劲[1] 刘之俊[1] 翁博文[1] 贾勇[1] 王奇[1] 邱志磊[1] 

机构地区：[1]青岛市市立医院东院泌尿外科,山东青岛266071

出　　处：《临床泌尿外科杂志》2010年第9期693-694,697,共3页Journal of Clinical Urology

摘　　要：目的:探讨前列腺囊肿的临床特征、诊断与微创治疗方法的选择。方法:回顾性分析7例前列腺囊肿患者的临床资料:3例因排尿不畅、尿线变细及排尿费力等就诊,3例以尿频、尿急及会阴部不适等类似前列腺炎症状就诊,1例因血精就诊。均经B超、MRI检查,对3例靠近前列腺尿道的较小囊肿行经尿道前列腺囊肿去顶术,对4例向尿道及膀胱顶后方突起的较大囊肿行腹腔镜下囊肿切除术。结果:7例患者均经B超、MRI联合确诊。经尿道手术时间30～40 min,出血20～50 ml;腹腔镜手术时间100～160 min,出血30～80 ml。术后引流2～3天,留置导尿管1～2周。所有患者术后随访1个月～2年,无尿路刺激症状,无排尿困难,阴茎勃起及射精功能正常。结论:经直肠B超和MRI是诊断前列腺囊肿的重要方法。对于靠近前列腺尿道的有症状的囊肿,经尿道前列腺囊肿去顶术疗效确切;当囊肿靠近尿道及膀胱顶的后方时,腹腔镜切除囊肿具有组织显露清楚、不易损伤盆腔组织、创伤小、出血少等优点,是治疗此类前列腺囊肿的最佳选择。Objective： To investigate the clinical characteristics, diagnostic methods and minimally invasive treatment of prostatic utricle cyst. Methods：We retrospectively analyzed the clinical data of 7 cases of prostatic utri cle cyst. Ages 19-72 years old, of whom 3 presented with difficult urination or thinning urinary stream, 3 with frequent or urgent micturition and the other 1 with hemospermia, All the cases underwent Transrectal uitrasonography and MRI. Transurethral cyst unroofing was performed for 3 of the patients with smaller cysts close to the prostatic urethra,and laparoscopic excision of the prostatic utricle was conducted for the other 4 with bigger cysts behind the prostatic urethra. Results：The duration of transurethral cyst unroofing ranged from 30 to 40min and intraoperative bleeding was 20-50 ml, the mean time of laparoscopic excision of the prostatic utricle was 100-160 min and intraoperative bleeding was 30-80 ml. All the patients were followed up for 1-24 months, which revealed normal penile erection and ejaculation and no urinary tract irritation or difficult urination. Conclusions：Transrectal Ultrasonography and MRI are excellent imaging modalities for accurate depiction of prostatic utricle cyst. Transurethral cyst unroofing is valuable for prostatic utricle cyst close to the prostatic urethra,Laparoscopic excision of the prostatic utricle, owing to its safety, effectiveness,minimal invasiveness, fewer complications and rapid recovery,can be used as the first choice for the treatment of prostatic utricle cyst.

关 键 词：前列腺囊肿 微创治疗 腹腔镜术 

分 类 号：R697[医药卫生—泌尿科学]