倒Y形保留功能尿道钬激光前列腺剜除术对术后尿失禁的影响  

Effect of inverted-Y urethral function-preserving holmium laser enucleation of the prostate on postoperative urinary incontinence

作　　者：宁金卓[1] 汪津润 程帆[1] 李浩勇[1] NING Jin-zhuo;WANG Jin-run;CHENG Fan;LI Hao-yong(Department of Urology,Renmin Hospital of Wuhan University,Wuhan,Hubei 430060,China)

机构地区：[1]武汉大学人民医院泌尿外科,湖北武汉430060

出　　处：《中华男科学杂志》2025年第1期45-49,共5页National Journal of Andrology

摘　　要：目的:分析倒Y形保留功能尿道钬激光前列腺剜除术对术后尿失禁的影响。方法:收集了2022年6月至2023年5月在武汉大学人民医院泌尿外科住院的109例良性前列腺增生患者的相关临床资料,进行回顾性分析。采用计算机生成的随机数字表来进行随机分组,将患者随机分为两组,A组52例进行传统保留前列腺尖部尿道瓣膜的钬激光前列腺剜除技术,B组57例进行倒Y形保留功能尿道钬激光前列腺剜除术。记录术中及术后相关指标。根据国际尿失禁状态推荐的标准,对患者尿失禁状态和排尿后症状进行评价。结果:B组拔管后压力性尿失禁率为10.52%,显著低于A组的26.92%(P=0.027);B组术后2周有1.75%的尿失禁率,而A组术后2周的尿失禁率为11.54%,A组尿失禁率明显高于B组(P=0.037);B组术后1个月尿失禁率同样明显低于A组(0 vs 7.69%,P=0.033)。结论:使用倒Y形保留功能尿道钬激光前列腺剜除术治疗良性前列腺增生相较于传统保留前列腺尖部尿道瓣膜的钬激光前列腺剜除术,能够使患者术后压力性尿失禁情况有较为明显的改善。Objective:To investigate the effect of inverted-Y urethral function-preserving holmium laser enucleation of the prostate(HoLEP)on stress urinary incontinence after surgery in patients with BPH.Methods:We retrospectively analyzed the clinical data on 109 cases of BPH treated in our hospital from June 2022 to May 2023 by traditional HoLEP with preservation of the apical prostatic urethral valve(group A,n=52)or inverted-Y urethral function-preserving HoLEP(group B,n=57).We recorded the intra-and post-operative parameters,evaluated the urinary incontinence status and post-void symptoms according to the International Continence Society standards,and analyzed the effect of inverted-Y versus traditional HoLEP in improving the postoperative urinary incontinence of the patients.Results:The incidence rate of stress urinary incontinence after catheter removal was significantly lower in group B than in A(10.52%vs 26.92%,P=0.027),and so was it at 2 weeks after surgery(1.75%vs 11.54%,P=0.037),and at 1 month postoperatively(0%vs 7.69%,P=0.033).Conclusion:For the treatment of BPH,inverted-Y urethral function-preserving HoLEP is superior to traditional HoLEP with preservation of the apical prostatic urethral valve in improving stress urinary incontinence after surgery.

关 键 词：钬激光前列腺剜除术 良性前列腺增生 压力性尿失禁 尿道外括约肌 

分 类 号：R699[医药卫生—泌尿科学]