前列腺剜除术导致尿失禁的力学因素浅析(附2270例报道)  

Analysis of mechanical factors on urinary incontinence induced by transurethral enucleation of prostate(TUEP) Report of 2270 Cases

作　　者：余闫宏[1] 姜安超 齐书武[1] 王田[1] 张宁南[1] 杨小华[1] 黄杰[1] 张科[1] 赵良运[1] 肖民辉[1] 

机构地区：[1]昆明理工大学医学院,云南省第一人民医院泌尿外科,云南650032 [2]云南中医学院

出　　处：《中国男科学杂志》2016年第1期34-37,共4页Chinese Journal of Andrology

摘　　要：目的初步探讨前列腺剜除术导致尿失禁的力学因素及避免的方法。方法 2003年5月到2012年12月,我科对前列腺增生患者施行传统前列腺剜除术和与基于力学分析改进的分叶分部位前列腺剜除术,对比两组术后尿失禁的发生率,分析剜出术中电切镜鞘对尿道括约肌可能的牵拉压迫,造成尿道括约肌损伤导致尿失禁。结果2003年5月到2008年7月间,我院行经传统尿道前列腺剜除术1560例,其中术后发生暂时性尿失禁95例(6.09%),永久性尿失禁8例(0.51%);2008年8月至2012年12月,行改进的分叶分部位前列腺剜除术1210例,暂时性尿失禁46例(3.80%),永久性尿失禁1例(0.08%)。结论传统前列腺剜除术有可能对尿道外括约肌造成机械损伤;基于力学分析,尽量保护外括约肌的改进的分叶分部位前列腺剜除术,与传统前列腺剜除术相比,尿失禁发生率较低。Objective To discuss the mechanical factors for transurethral enucleation of prostate（TUEP）-induced urinary incontinence, and explore the way to avoid it. Methods The occurrence rates of urinary incontinence of 2770 benign hyperplasia of prostate （BPH） patients who underwent traditional TUEP and modified TUEP respectively were comparatively analyzed. The possible linkage between the mechanical damage on urethral sphincter by resectoscope and the occurrence rate of urinary incontinence was further defined. Results From May 2003 to July 2008, 1560 patients were treated with traditional TUEE Temporary urinary incontinence accounted for 6.09% （95 patients ）, and permanent urinary incontinence 0.51%（8 patients）. Other 1210 patients were treated with modified TUEETemporary urinary incontinence accounted for 3.80%（46 patients）, and permanent urinary incontinence 0.08%（1 patient）. Conclusion The traditional TUEP may cause mechanical damage on urethral sphincter by resectoscope, and the modified TUEP shows lower occurrence rate of urinary incontinence.

关 键 词：前列腺增生 经尿道前列腺切除术 尿失禁 力学 

分 类 号：R697.32[医药卫生—泌尿科学] R694.54[医药卫生—外科学]