完整保留精道周围结构及膀胱颈的前列腺剜除术治疗低龄前列腺增生患者的效果分析  

Effect of enucleation of prostate in treatment of young patients with prostatic hyperplasia with reserved intact ejaculatory duct structure and bladder neck

作　　者：井俊峰 齐伟[1] 张路锋 魏灿[1] 席俊华[1] 张艳斌[1] Jing Junfeng;Qi Wei;Zhang Lufeng;Wei Can;Xi Junhua;Zhang Yanbin(Department of Urology,the Second Peoples Hospital of Hefei,Hefei 230011,China)

机构地区：[1]合肥市第二人民医院泌尿外科,合肥230011

出　　处：《国际泌尿系统杂志》2024年第3期486-489,共4页International Journal of Urology and Nephrology

基　　金：蚌埠医学院自然科学重点项目(2020byzd307)。

摘　　要：目的:探讨完整保留精道周围结构及膀胱颈的前列腺剜除术对低龄前列腺增生患者排尿功能、即刻尿控及逆行射精发生率的影响。方法:回顾性分析2018年6月至2021年3月本院收治的60例前列腺增生患者的临床资料,通过随机数表法将患者分为改良组及对照组,每组各30例。改良组完整保留精道周围结构及膀胱颈,对照组行常规分叶前列腺剜除术。记录并比较两组的手术时间、膀胱冲洗时间、留置尿管时间、即刻及术后尿控率、术后3个月及6个月的最大尿流率、国际勃起功能评分(IIEF-5)、国际前列腺症状评分(IPSS)、逆行射精(RE)发生率。结果:改良组的即刻尿控率高于对照组,差异有统计学意义(P<0.05);改良组术后3个月的IIEF-5评分优于对照组,差异有统计学意义(P<0.05);术后3个月和术后6个月改良组的RE发生率低于对照组,差异均有统计学意义(均P<0.05)。结论:完整保留精道周围结构及膀胱颈的前列腺剜除术与常规前列腺剜除术效果相当,但即刻尿控率、RE发生率及早期性功能恢复优于常规手术,适用于低龄、需要保留正常射精功能的患者。Objective To investigate the effect of prostatectomy with complete preservation of intact ejaculatory duct structure structure and bladder neck on urination function,immediate urination control and incidence of retrograde ejaculation in young patients with prostate hyperplasia.Methods The clinical data of 60 patients with prostatic hyperplasia admited to our hospital from June 2018 to March 2021 were retrospectively analyzed.The patients were divided into improved group and control group by random number table method,with 30 cases in each group.The operative time,bladder irrigation time,catheter retention time,immediate and postoperative urinary control rate,maximum urinary flow rate at 3 and 6 months after surgery,International Erectile Function Score(IEF-5),International Prostatic Symptom Score(IPSS),and incidence of retrograde ejaculation were recorded in both groups.Results The immediate urine control rate in the improved group was higher than that in the control group,the difference was statistically significant(P<0.05).The IIEF-5 score of the improved group was better than that of the control group at 3 months after operation,and the difference was statistically significant(P<0.05).The incidence of RE in the improved group was lower than that in the control group at 3 months and 6 months after surgery,and the difference was statistically significant(all P<0.05).ConclusionssProstatic enucleation with complete preservation of the perispermal structure and bladder neck has the same effect as conventional prostatic enucleation,but the incidence of immediate urinary control,incidence of RE and early recovery of sexual function are superior to conventional surgery.It is suitable for young patients who need to retain normal ejaculation function.

关 键 词：前列腺增生 前列腺切除术 膀胱颈 精道 

分 类 号：R699.8[医药卫生—泌尿科学]