经尿道柱状水囊前列腺扩开术结合钬激光治疗膀胱颈部挛缩的初步体会  

Transurethral Columnar Balloon Dilatation of the Prostate combined with Holmium laser for Bladder Neck Contracture in Day-Surgery Mode

作　　者：孙杰[1] 夏盛强 童臻[1] 陈斌[1] Sun Jie;Xia shengqiang;Tong Zhen;Chen Bin(Department of Urology,Renji Hospital affiliated to Shanghai Jiao Tong University Medical School,Shanghai,China)

机构地区：[1]上海交通大学医学院附属仁济医院泌尿科,上海200127

出　　处：《中国男科学杂志》2022年第4期88-91,共4页Chinese Journal of Andrology

基　　金：上海市卫生和计划生育委员会面上项目(201840300)支持。

摘　　要：目的探讨经尿道柱状水囊前列腺扩开术(TUCBDP)结合钬激光治疗膀胱颈部挛缩的有效性和安全性,并且评价该术式在日间模式下的应用价值。方法回顾性分析2020年1月至2021年7月我院收治的46例前列腺术后膀胱颈部挛缩患者。根据患者接受手术方式不同分为TUCBDP结合钬激光治疗组及单纯钬激治疗组。门诊完成各项检查,24小时内完成入院、手术、出院。随访术后的IPSS、Qmax、残余尿量以及并发症发生情况。结果本研究46例患者均顺利完成手术。所有患者排尿困难症状较术前明显缓解。两组间比较,TUCBDP联合钬激光组在术后6月排尿参数(IPSS、Qmax、PVR)优于单纯钬激光组,结果有统计学意义(P<0.05)。两组术后半年内各有1例压力性尿失禁发生。单纯钬激光组在术后半年随访中有4例患者出现BNC复发再次行手术治疗。结论经尿道柱状水囊前列腺扩开术结合钬激光治疗膀胱颈部挛缩总体疗效肯定、操作相对简单,并且术后恢复快,复发率低,是一种值得日间手术推广应用的微创治疗方法。Objective To observe clinical effect of transurethral columnar balloon dilatation of the prostate combined with Holmuim laser for the treatment of bladder neck contracture.Methods A total of 46 patients with BNC who were treated by transurethral columnar balloon dilatation of the prostate in our hospital from Jan.2020 to Jul.Patients were divided into two groups according to the methods of surgery.The admission,operation and discharge of all patients were completed in 24 hours.Clinic parameters such as IPSS,Qmax,QOL and PVR were recorded.Results All the patients underwent operations successfully.The symptoms of all patients were significantly relieved compared with those before surgery.Urinary parameters(IPSS,Qmax,and PVR)in TUCBDP combined with holmium laser at 6 months after surgery were significantly better than those in the holmium laser group alone(P<0.05).There were 2 case of stress urinary incontinence in both groups within half a year after operation.In the holmium laser group,there were 4 patients with BNC recurrence in 6 months of follow-up after surgery.Conclusion Transurethral columnar balloon dilatation of the prostate combined with Holmium can effectively treat BNC,with simple performance and satisfactory clinical effects.It is a minimally invasive treatment that is worthy of the popularization of day-surgery.

关 键 词：膀胱颈挛缩 经尿道柱状水囊前列腺扩开术 钬激光 

分 类 号：R699.8[医药卫生—泌尿科学] R454.21[医药卫生—外科学]