保留尿道括约功能的前列腺癌根治术165例报告  

Urethral sphincter preservation procedure in 165 cases of prostatectomy

作　　者：白强[1] 王振声[1] 李青[1] Glenice wilson Margaret McCarthy Keith W Kaye 

机构地区：[1]山东省千佛山医院泌尿外科,济南250014 [2]西澳大学伊丽莎白医学中心

出　　处：《中华泌尿外科杂志》2001年第8期483-486,共4页Chinese Journal of Urology

摘　　要：目的　探讨保留尿道括约功能的前列腺癌根治术后病人发生尿失禁的影响因素。　方法　采用尿道外括约肌保留、膀胱颈及前列腺前括约肌 (PPS)保留、勃起神经保留等方法行前列腺根治手术 16 5例。通过调查表和尿垫试验 ,从主观和客观两方面进行随访。　结果　尿道外括约肌保留组尿失禁发生率为 0 .7% ,括约肌修复组为 5 .3% ;按年龄分组 :5 0岁～组拔除导尿管时 ,6 0 %出现尿失禁 ,6 0岁～组拔除导尿管时 ,82 %出现尿失禁。但 3个月以后 ,两组趋于一致。　结论　外科技术和病人年龄是影响根治性前列腺切除术后尿失禁发生的重要因素 ,保留尿道外括约肌及保留尿控制机制可以减少术后尿失禁发生率。年轻病人术后易恢复尿控状态 。Objective To assess the urinary continence at a follow-up of 1 year after radical retro-pubic prostatectomy. Methods By using subjective (questionnaire) and objective (pad-test) methods, 165 consecutive prostate cancer patients were followed up at least 1 year. With the purpose to improve post-operative continence, surgical techniques such as preservation of external striated sphincter, preservation of bladder neck and pre-prostate sphincter (PPS), and nerve-sparing technique have been carried out.Analyses were also made in comparison by age. Results A post-operative incontinence rate of 0.7% was found in the sphincter preserving group and 5.3% in the sphincter repairing group. Patients aged 50～60 revealed a continence rate of 60% when the urethral catheter was removed, whereas 82% in the 60～70 group.After 3 months of follow-up, the continence rate of both age groups tended to be similar. Conclusions Surgical improvement and patients' age are important factors in post-operative continence after radical retro-pubic prostatectomy. The preservation of external urethral sphincter helps improve continence rate. Younger patients tend to regain to continence in a shorter period while the elders longer.

关 键 词：前列腺肿瘤 癌 前列腺切除 尿失禁 尿道括约肌功能 

分 类 号：R737.25[医药卫生—肿瘤]