耻骨上经膀胱手术与经尿道电切术治疗前列腺增生症的比较

目的 比较耻骨上经膀胱手术与经尿道前列腺电切术(TURP)治疗前列腺增生症术后尿失禁的发生情况.方法 将135例患者分为两组:82例行耻骨上经膀胱手术(SPP),53例行TURP.观察两组尿失禁的总发生率,按Stamey尿失禁分级系统观察严重程度、尿失禁持续时间,对持续1周以上者行尿动力学检查,分析其类型.结果 SPP组尿失禁的总发生率、严重程度、持续时间均高于TURP组,术后尿动力学分析发现,发生压力性尿失禁者SPP组高于TURP组,发生急迫性尿失禁者两组差异无统计学意义.结论 从预防术后尿失禁角度,TURP术优于sPP术.sPP术后发生压力性尿失禁多见,分析可能与手术切除彻底,且易损伤膜部尿道黏膜有关.

Observation of post-prostatectomy incontinence :supra-pubic transvesical prostatectomy and transurethral resection of prostate

Objective To evaluate the morbidity of the post-prostatectomy incontinence of supra-pubic transvesical prostatectomy(SPP) and transurethral resection of prostate(TURP). Methods One hundred and thirtyfive patients were divided into two groups. 82 patients underwent SPP and 53 patients underwent TURP. We ob-served the morbidity and the time lasting of post-prostatectomy incontinence, the severity of post-prostatectomy in-continence as evaluated by Stamey incontinence grading system,patients who had more than one week postoperativeincontinence were received urodynamic tests,then we got the information of their incontinence types. Results We found that patients who underwent SPP had higher morbidity, severity and time lasting than those who underwent TURP. SPP group had much more morbidity of stress incontinence than TURP group, but the same morbidity of ur-gent incontinence after operation as the later. Conclusion TURP may be better than SPP in consideration of the post-prostateetomy incontinence. SPP group has more stress incontinence and it may be caused by complete resection of prostate and damnifieation of the mucous membrane of membranous urethra.