膀胱壁新尿道技术在腹腔镜根治性前列腺切除术后早期控尿中的作用  

Bladder wall neourethra technique improves early urinary continence after laparoscopic radical prostatectomy

作　　者：许志斌 郭毛毛 卞浩 李振迟 王晨 洪增旭 赵杰 官正辉 王江平 XU Zhi-bin;GUO Mao-mao;BIAN Hao;LI Zhen-chi;WANG Chen;HONG Zeng-xu;ZHAO Jie;GUAN Zheng-hui;WANG Jiang-ping(Department of Urology,Taizhou People's Hospital,Taizhou,Jiangsu 225300,China)

机构地区：[1]泰州市人民医院泌尿外科,江苏泰州225300

出　　处：《中华男科学杂志》2022年第10期886-890,共5页National Journal of Andrology

摘　　要：目的:观察和分析膀胱壁新尿道(BWN)技术对腹腔镜根治性前列腺切除术(LRP)后早期控尿的影响。方法:前瞻性选取我院自2020年8月至2021年8月行LRP的40例患者,随机分为BWN组(20例)和对照组(20例)。比较两组患者拔除尿管后第7、30、90、180天的控尿情况,拔除尿管1个月后的最大尿道压(MUP)、功能尿道长度(FUL)、功能尿道面积(UFA),并采用MRI观察新尿道闭合形态。结果:BWN组和对照组拔除尿管后第7、30、90、180天控尿率分别为90.0%vs 25.0%(P<0.001)、95.0%vs 35.0%(P<0.01)、 100.0%vs 60.0%(P<0.05),100.0%vs 90.0%(P>0.05)。BWN组和对照组MUP无明显差异(P>0.05),BWN组FUL、FUA显著高于对照组(P<0.01)。MRI显示BWN组新尿道在储尿期紧密闭合。结论:BWN技术可以显著延长FUL,提高LRP后早期尿控。Objective: To study the effect of the bladder wall neourethra(BWN) technique on early urinary continence after laparoscopic radical prostatectomy(LRP). Methods: We prospectively selected 40 cases of LRP performed in our hospital from August 2020 to August 2021 and randomly divided them into a BWN group(n = 20) and a control group(n = 20). We recorded the urinary continence rate of the two groups of patients at 7, 30, 90 and 180 days, and measured the maximum urethral pressure(MUP), functional urethral length(FUL) and functional urethral area(UFA) and observed the shape of the neourethra closure by MRI at 1 month after catheter removal. Results: The urinary continence rates were significantly higher in the BWN than in the control group at 7 days(90.0% vs 25.0%, P < 0.001), 30 days(95.0% vs 35.0%, P < 0.001), 90 days(100% vs 60.0%, P < 0.05) and 180 days(100% vs 90.0%, P > 0.05) after catheter removal. No statistically significant difference was observed in MUP between the two groups(P > 0.05). FUL and FUA were remarkably higher in the BWN than in the control group(P < 0.01). MRI showed tight closure of the neourethra in the BWN group in the urine storage period. Conclusion: The BWN technique can significantly prolong FUL and improve early urinary continence after LRP.

关 键 词：腹腔镜根治性前列腺切除术 尿失禁 尿控 新尿道 

分 类 号：R699.6[医药卫生—泌尿科学]