改良的Madigan前列腺切除术

目的　对Madigan前列腺切除术 (MPC术 )进行改良 ,提高手术疗效。　方法　对 52例前列腺增生 (BPH)患者行MPC术 ,并进行手术改良。包括 :(1)显露膀胱颈及尿道起始部以避免或减少尿道损伤 ;(2 )联合膀胱顶部小切口以治疗中叶增生显著和 (或 )合并膀胱病变的BPH。结果　尿道完整或基本完整者 48例 ,术中出血较少 ,平均手术时间 12 0min。其中 3 5例获随访 ,随访时间 1～ 12个月 ,术后平均最大尿流率 18 9ml/s;8例患者手术前后行排尿期膀胱尿道造影 ,证实术后前列腺部尿道及膀胱颈完整 ,尿道较术前明显增宽。　结论　改良的MPC术减少了尿道损伤的发生 ,扩大了MPC术的适应证 ,手术操作简便、并发症少 ,疗效确切

Modified Madigan prostatectomy

Objective To improve Madigan prostatectomy (MPC) for a much satisfactory effect in open surgery. Methods A total of 52 patients with benign prostatic hyperplasia (BPH) were treated using MPC. The MPC procedure was modified by exposing anterior prostatic urethra near the bladder neck and conjuncting with cystotomy. This modified procedure preserved prostatic urethra intact and could also deal with intracystic lesions at the same time. Results The intact of prostatic urethra was kept completely or almost for 48 cases. The hemorrhage amount during modified procedure was a less. The mean operative time was 120 minutes. The 35 patients had been followed up for 1 12 months. The average Qmax was 18 9 ml/s. The cystourethrography revealed that the urethra and bladder neck were intact in 8 patients postoperatively. Furthermore, the prostatic urethra was obviously wider after modified MPC. Conclusions The modified MPC can reduce the urethra injury and enlarge the MPC indications. The modified technique is easy to perform with little complications and much more satisfactory clinical result. The modified MPC is highly recommended.