良性前列腺增生汽化电切术后尿动力学研究

目的应用尿动力学检查指标对经尿道前列腺汽化电切术(transurethral electrovaporization of the prostate,TU-VP)后的尿动力学改变进行研究.方法43例良性前列腺增生患者(年龄54～81岁,随访时间2～22个月),按TUVP术后随访时间分为A组(18人,随访时间2～4个月)、B组(13人,5～12个月)、C组(12人,13个月以上),分别进行术前、术后的国际前列腺症状评分和尿动力学检查,并进行统计学分析.结果与术前相比,IPSS评分由22.60分减少到11.63分,最大尿流率由7.87 ml/s上升至16.51 ml/s,最大尿流率时膀胱逼尿肌压由78.41 cmH2O(32例)下降至40.00 cmH2O(26例),提示梗阻得到解除;膀胱顺应性由22.76 ml/cmH2O升至41.11ml/cmH2O,最大尿意膀胱容量由285.93ml升至339.63ml,合并不稳定膀胱的患者由16例降至术后3例,提示膀胱功能得到恢复;3组病人间对比无梗阻症状复发的迹象.结论本研究以客观的指标证实TUVP可切实的解除由良性前列腺增生所致的膀胱流出道梗阻,术后效果稳定.

Outcomes of transurethral electrovaporization of the prostate using urodynamic criteria

Objectives To evaluate the outcomes of patients with benign prostatic hyperplasia (BPH) treated by transurethral electrovaporization of the prostate (TUVP) by using urodynamic parameters. Methods According to the follow up time, a total of 43 patients (age: 54-81 years, follow up time: 2-22 months) undergoing TUVP were divided into group A ( n =18, follow up time: more than 13 months ), group B ( n =13, follow up time: 5-12 months ) and group C ( n =12, follow up time: more than 13 months ), and were evaluated preoperatively and postoperatively by using International Prostatic Symptom Score (IPSS), uroflowmetry, cystometry, press flow urodynamic study, and urethral pressure profile. Results Compared with those before operation, the IPSS decreased from 22.60 to 11.63; peak outflow rate (Qmax) increased from 7.87 ml/s to 16.51 ml/s, whereas detrusor pressure at peak flow (PdetQmax) decreased from 78.41 cmH 2O ( n =32) to 40.00 cmH 2O ( n =26), indicating relief of the obstruction; bladder compliance increased from 22.76 ml/cmH 2O to 41.11 ml/cmH 2O; maximal voiding desire volume increased from 285.93 ml to 339.63 ml; and the number of patient who had had unstable bladder decreased from 16 to 3, indicating recovery of some bladder functions. Conclusion TUVP is an effective method for the relief of bladder outlet obstruction resulted from BPH.