前列腺切除术后排尿困难18例临床分析

目的　探讨前列腺切除术后排尿困难的原因及防治措施。方法　对 18例前列腺切除术后排尿困难患者的临床资料进行回顾分析。结果　膀胱颈部狭窄 10例 ,后尿道狭窄 3例 ,前尿道狭窄 1例 ,腺体残留 3例 ,膀胱逼尿肌功能障碍 1例。尿道扩张联合开放手术或腔内电切术治愈 17例 ,永久性膀胱造瘘 1例。结论　膀胱颈部狭窄、尿道狭窄、腺体残留、膀胱逼尿肌功能障碍是术后排尿困难的主要原因 ,多由医源性因素引起。术前行尿流动力学检查、术中术后操作得当可以避免这些并发症。尿道扩张联合开放手术或腔内电切术是前列腺切除术后排尿困难较为有效的治疗方法。

Clinical AnaIysis of 18 Cases of Dysuria after Prostatectomy

Objective To explore the causes, prevention and treatment of dysuria after prostatectomy.Methods From 1993 to 2004, 18 cases of dysuria after prostatectomy were reviewed and analyzed. Results The bladder neck stricture was found in 10 cases, retral urethral stricture in three, foreside urethral stricture in one, and adenomatous remains in three. Bladder detrusor dysfunction in 17 cases was cured by urethral dilatation plus open operation or transurethral electroresection, and there was one case that was made fistula in the bladder. Conclusion Bladder neck stricture, urethral stricture, adenomatous remains and bladder detrusor dysfunction are the main causes of dysuria. Urodynamics test and logical operation can avoid the complications. Urethral dilatation combined open operation or transurethral electroresection is an effective means to dysuria after prostatectomy.