TURP术后尿道狭窄原因分析

目的：探讨减少经尿道前列腺切除术 （TURP） 术后尿道狭窄的有效办法.方法：回顾性分析 2000 年 3 月 -2011 年 12 月 TURP 治疗良性前列腺增生 （BPH）408 例的临床资料,根据手术方法的改变及不同,将其分为两组：A 组 186 例,B 组 222 例,对两组相关指标进行统计对比.结果：A 组平均手术时间 （110±30）min,术中出血量 （425±375）ml,包膜穿孔尿外渗 6 例 （3.22%）,总尿道狭窄 20 例 （10.75%）,尿道外口狭窄 12 例 （6.45%）,后尿道狭窄 6 例 （3.22%）,术后暂时尿失禁 10 例 （5.37%）,术后 1 月内继发性出血 13 例 （6.98%）;B 组则分别为 （57.5±27.5）min、（115±105）ml、0 例、6 例 （2.70%）、4 例 （1.80%）、1 例 （0.45%）、4 例 （1.80%）、6 例 （2.70%） 例,均能顺利入镜,两组比较差异有统计学意义 （P〈0.05）.结论：TURP 应选择腺体 〈70 ml 病例,术前有尿道外口相对狭窄经一次尿道扩张仍不能顺利入镜者则行尿道口背侧切开,一旦发现包膜穿孔或静脉窦弥漫出血则尽快结束手术,尽量缩短手术时间,可明显减少术后尿道狭窄及其他并发症发生.

Analysis of the Cause about TURP Urethral Stricture

Objective：To explore the effective measures about to reduce the TURP urethral stricture.Method：Retrospective analysis 408 BPH cases with TURP treatment in the last 11 years, according to the different of operation methods, and which was divided into two groups： group A in 186 cases, group B in 222 cases, with Statistical comparison in two groups of indicator.Result ：Group A： the average operation time （rain） was （110 ± 30）, bleeding （ml） was （425 ± 375） during operation, capsular perforation urinary extravasation was 3.2%, the whole urethral stricture was 10.75%, the narrow of external orifice of urethra was 6.45%, the narrow of posterior urethral was 3.2% , after urethral stricture, postoperative temporary uroclepsia was 5.3%, secondary hemorrhage was 6.9% after one month; Group B ： （57.5±27.5） , （115±105）, 0 , 2.7%, 1.8%, 0.45%, 1.8%, 2.7%. Two groups of comparisons was statistically significant （P〈0.05）. Conclusion ：TURP should choose cases which the glands 〈 70 ml, cut the back side which cannot smooth Rujing after expend narrow urethra one time, end the operation as soon as once found capsular perforation or bleeding in venous sinus, try to shorten the operation time, can obviously reduce postoperative urethral stricture and other complications.