经尿道腔内手术治疗女性膀胱颈梗阻(附33例报告)  

Transurethra endoscopic surgical treatment of female bladder neck obstruction (Report of 33 cases)

作　　者：樊松[1] 张贤生[1] 张翼飞[1] 郝宗耀[1] 周骏[1] 江长琴[1] 陈先国[1] 邰胜[1] 梁朝朝[1] 

机构地区：[1]安徽医科大学第一附属医院泌尿外科,合肥230022

出　　处：《临床泌尿外科杂志》2013年第5期373-374,共2页Journal of Clinical Urology

摘　　要：目的:提高经尿道腔内手术治疗膀胱颈部梗阻的诊治水平。方法:对33例保守治疗无效的膀胱颈部梗阻女性患者行经尿道膀胱颈部电切术。结果:28例患者(84.8%)术后排尿症状明显改善,在手术后6～12周梗阻症状消失。最大尿流率和剩余尿量明显改善,手术前后平均尿流率分别为(6±4)ml/s、(28±10)ml/s(P<0.05)。切除的膀胱颈部组织病理报告为纤维平滑肌组织增生伴或不伴慢性炎细胞浸润。随访6～58个月,平均18个月,5例在术后2～4年膀胱颈部梗阻症状复发,3例行再次电切后症状改善,2例再次电切,随访3个月无效后行膀胱造瘘术。均未发生尿失禁和尿瘘等并发症。结论:经尿道电切术治疗女性膀胱颈部梗阻手术操作简单、创伤小、出血少,疗效肯定。To improve the diagnosis and treatment of bladder neck obstruction by urethral endo scopic surgery. Method=Thirty-three cases of bladder neck obstruction in female patients after invalid conservative therapy were treated with transurethral resection of bladder neck. Result： Twenty eight patients （84.8%） postoperative voiding symptoms improved significantly, the disappearance of obstructive symptoms in the 6 to 12 weeks after surgery. The maximum flow rate and residual urine volume was significantly improved in the average flow rate before and af ter surgery were （6±4 ）, （28±10） ml per second, respectively （ P〈0.05）. Resection of bladder neck tissue were reported for the fiber smooth muscle tissue proliferation with or without chronic inflammatory cells. After 6 to 58 months follow-up, with an average of 18 months, five cases had recurrence of symptoms after 2 4 years , symptoms of 2 cases improve by transurethral surgery again; 2 cases underwent bladder fistulization after 3 months follow up. There is no oc currenee of urinary incontinence and urinary fistula complications. Conclusion： Transurethral resection of bladder neck obstruction is simple and effective method with less trauma, less bleeding. As to moderate and sever or mild pa tients with poor response to medication, transurethral bladder neck excision procedure is recommended.

关 键 词：膀胱颈部梗阻 经尿道膀胱颈电切术 

分 类 号：R694[医药卫生—泌尿科学]