前列腺切除术后尿失禁影响因素分析

目的：总结良性前列腺增生癌患者耻骨上经膀胱前列腺切除术和经尿道前列腺电切除术术后尿失禁的影响因素、预防措施及手术时机的选择。方法：将415例患者分为2组：197例行耻骨上经膀胱前列腺切除术，218例行经尿道前列腺电切除术。术前行相关尿流动力学检查，术后2组患者行1个月，6个月，12个月追踪随访。结果：80％以上的良性前列腺增生症患者术前合并膀胱功能改变，术后尿失禁患者均发生于失代偿的患者。结论：前列腺切除术后尿失禁的因素是多方面，膀胱功能障碍是其主要原因之一，通过尿流动力学检查术前评估患者的膀胱和括约肌功能，合理把握手术时机，争取在膀胱代偿期解决梗阻，可以减少术后尿失禁的发病率。

Analysis of urinary incontinence after prostatectomy

ObjectiveTo analysis the influence factors, prevention measures of post-prostatectomy incontinence, and operation opportunity of benign prostate hyperplasia. Methods Four hundred and fifteen patients were divided into two groups. 197 patients underwent supra-pubic transvesical prostatectomy and 218 patients underwent transurethral resection prostate. All these 415 patients received urodynamic tests before prostatectomy, and were followed up in 1, 6 and 12 months after prostatectomy. Results Of all the patients, over 80% had bladder dysfunction before prostatectomy, and all patients with post-prostatectomy incontinence had bladder dysfunction before prostatectomy. Conclusion Bladder dysfunction is one of the major factors causing incontinence after proastatectomy. Thorough urodynamic tests help us to estimate function of bladder and urethrs sphincter, and to reduce the morbidity of incontinence by performing prostatectomy in compensatory stage of bladder.