经尿道汽化电切加撬剥术治疗良性前列腺增生600例疗效观察

目的探讨经尿道汽化电切加撬剥术治疗良性前列腺增生的疗效与并发症。方法回顾分析600例前列腺增生患者于尿道汽化电切术中利用镜鞘及电切袢对剩余腺体撬剥的手术过程、临床疗效及手术并发症等资料。结果采用汽化电切加撬剥剩余腺体,界面清楚、止血容易。全组手术时间为25～110min,平均50min。术中包膜穿孔10例;术后拔尿管后排尿困难而再次留置尿管者45例(占7.5%);无发生经尿道电切综合征者。术后随访1～12个月,迟发性出血致膀胱填塞2例,尿道狭窄35例(占5.8%)。无永久性尿失禁。国际前列腺症状评分、生活质量评分、残余尿量和最大尿流率与术前比较,差异均有统计学意义(P<0.05)。结论经尿道汽化电切加撬剥治疗良性前列腺增生疗效确切、安全、可靠,并发症少,是一种理想的微创治疗。

Transurethral Vaporization and Prying Prostatic Tissue for the Treatment of Benign Prostatic Hyperplasia:A report of 600 cases

Objective To summarize the clinical effect and complications in the treatment of benign prostatic hyperplasia(BPH)by using transurethral vaporization of the prostate(TUVP)and prying prostatic tissue.Methods The data of 600 patients with BPH who underwent treatment of TUVP and prying prostatic tissue were retrospectively analyzed,including operational processes,clinical effect and complications.Results The interface of incision was clear and the hemostasia was easy in the operational process by using TUVP and prying remaining prostatic tissue.The operative time ranged from 25 to 110 min(mean 50 min).There were 10 cases who got intraoperative perforation of prostate envelope,and 45 cases who were indwelling catheter for voiding difficulty(7.5%).No transurethral resection syndrome occurred.All patients were followed up for 1 to 12 months after treatment.There were 2 cases with postoperative bleeding,and 35 cases with urethral stricture(5.8%).No permanent urinary incontinence occurred.There were obvious changes in scores of IPSS,Qmax and QOL,and RUV after treatment as compared with those before,with significant differences(P<0.05).Conclusion TUVP plus prying prostatic tissue is an effective,safe and reliable method for the treatment of BPH,with fewer complications.It is an ideal microtraumatic remedy.