BPH术后前列腺尿道创面囊泡样化生31例分析  

Analysis of 31 Cases of Vesicular Chemosis in Prostatic Urethral Trauma After BPH Surgery

作　　者：钱余 周恩谱 黄进宝 Qian Yu;Zhou Enpu;Huang Jinbao(Department of Urology,Kongjiang Hospital,Shanghai,200093,China)

机构地区：[1]上海市控江医院泌尿外科,上海200093

出　　处：《黑龙江医学》2024年第2期136-139,共4页Heilongjiang Medical Journal

基　　金：上海市杨浦区卫健委医学重点学科资助项目(YP19ZB06)。

摘　　要：目的:分析31例良性前列腺增生(Benign prostatic hyperplasia,BPH)患者经尿道切除术后,前列腺尿道创面囊泡样化生的诊治,为临床提供参考。方法:选取2012年1月—2021年12月上海市控江医院收治的31例良性前列腺增生术后前列腺尿道创面出现囊泡样病变合并出血患者作为研究对象。膀胱镜检查提示,患者前列腺尿道创面出现大量囊泡样组织增生及部分前列腺腺体残留。给予所有患者再次经尿道前列腺残留腺体切除和囊泡切除。观察患者治疗效果、围手术期指标、排尿及控尿功能、安全性评价等指标。结果:手术后,患者前列腺内腺体积、国际前列腺评分表(international prostate symptomscore,IPSS)评分、残余尿量、最大尿流率较术前改善,差异有统计学意义(t=6.86、5.66、3.37、3.09,P<0.05)。术后切出的标本再次做病理检查,诊断为“前列腺组织合并囊泡化生”。术后随访6~12个月,所有患者血尿消失,排尿通畅。复查膀胱镜结果显示,前列腺尿道创面光整,膀胱颈无抬高,未发现囊泡。结论:良性前列腺增生患者经尿道切除术后若出现远期出血或血尿,需经膀胱镜检查上次手术创面是否有前列腺组织残留及囊泡化生。一旦发生,需再次手术切除增生的囊泡和残留前列腺腺体,以获满意效果。Objective:To analyze the diagnosis and treatment of vesicular chemosis in prostatic urethral trauma after transurethral resection of 31 cases of benign prostatic hyperplasia for clinical reference.Methods:31 patients admitted to the hospital from January 2012 to December 2021 with vesicular lesions combined with hemorrhage in the prostatic urethral trauma after surgery for benign prostatic hyperplasia were selected for the study.Cystoscopy suggested that the patient had a large amount of vesicular tissue hyperplasia and some prostate gland remnants in the prostatic urethral wound.Re-transurethral residual prostate adenomectomy and vesicle resection were given to all patients.The treatment effect,perioperative indexes,urination,urinary control function,and safety evaluation of patients were observed.Results:After surgery,the patients’intraprostatic gland volume,IPSS score,residual urine volume,and maximal urinary flow rate improved compared with the preoperative period,and the difference was statistically significant(t=6.86,5.66,3.37,3.09,P<0.05).The postoperative specimen was again pathologically examined,and the diagnosis was“prostate tissue combined with vesicular metaplasia”.The patients were followed up for 6 to 12 months after the operation,and the hematuria disappeared and the urination was smooth.Repeat cystoscopy showed a smooth prostatic urethral wound with no elevation of the bladder neck and no vesicles were found.Conclusion:If distant bleeding or hematuria occurs after transurethral resection in patients with benign prostatic hyperplasia,the last surgical wound needs to be examined cystoscopically for residual prostatic tissue and vesicular hyperplasia.Once it occurs,another surgery is needed to remove the hyperplastic vesicles and residual prostate glands to get a satisfactory result.

关 键 词：良性前列腺增生 囊泡化生 经尿道前列腺切除术 血尿 

分 类 号：R699[医药卫生—泌尿科学]