Madigan术切除前列腺增生的疗效及其并发症的临床研究

目的探讨Madigan术切除前列腺增生的临床疗效。并分析其术后并发症产生的原因。方法对48例良性前列腺增生（BPH）患者，以Madigan术切除前列腺增生，总结了手术时间、出血量及术后各种并发症的发生率；分析各种并发症的具体情况和产生原因，并通过统计学方法与传统的经膀胱前列腺切除术临床结果进行对比。结果Madigan术切除前列腺增生。手术用时较长；而术中出血量、术后膀胱冲洗时间、留置导尿管时间及住院时间均短于传统方法（P〈0．05）；最大尿流率和残余尿量则无显著性差异（P〉0．05）。术中有31例患者发生部分尿道损伤。但维持了该部分受损尿道的纵行连续性。术后未见对疗效有明显影响；Madigan术后并发症的主要表现是出血和感染。结论经耻骨后保留尿道行Madigan术。是开放手术治疗良性前列腺增生较为安全、有效而经济的术式。

Clinical Analysis of Outcome and Complications of Madigan Prostatectomy for Benign Prostatic Hyperplasia

Objective To determine the clinical outcome of Madigan prostatectomy for benign prostatic hyperplasia and the causes of complications. Methods Madigan prostatectomy was performed to 48 patients with benign prostatic hyperplasia. The outcome of operation and postoperative complications were summarized and analyzed in comparison with the results of the cystoprostatectomy. Results The operation time of Madigan prostatectomy was longer, but the bleeding in operation, the mean volume of irrigating fluid used, the duration required urethral catheters and staying in hospital was significantly reduced (P<0.05) and the other indexes showed no significant differences(P>0.05). There were 31 cases of urethra injury occurred in operation and no case with significant influences on the outcome. The major complications of Madigan prostatectomy were bleeding and infection. Conclusions As an open surgery, Madigan prostatectomy is safe, efficient and economic for the patients with benign prostatic hyperplasia.