改良Madigan术切除前列腺中叶增生

目的：改良Madigan术式治疗前列腺中叶增生。方法：对22例前列腺增生患者采用了先行耻骨后保留尿道切除膀胱颈以远的腺体；再经膀胱入路，在突入膀胱腔内的增生中叶腺体的前壁作远离尿道内口2cm的弧形切口，直视下分离膀胱颈和尿道后壁的粘膜，完整切除腺体，直视下修剪并缝合固定粘膜，将膀胱与腺窝隔离，同时处理膀胱内的其它病变。结果：本组22例手术顺利，出院时测最大尿流率14．0－24．5ml/s，IPSS平均4．5分，B超测定剩余尿≤20ml。术后21例随访3－30个月，最大尿流率未降低，无尿道狭窄，排尿通畅。结论：我们在实际操作过程中达到切除全部增生腺体，完整保留了尿道组织，直视下修剪并缝合固定膀胱后唇粘膜，将膀胱与腺窝隔离，同时处理了膀胱内的其它病变，操作方便，无后顾之忧。

Incision of benign hypertrophy of prostate of improved Madigan

Purpose: Modified Madigan's prostatectomy was used to treat the prostatic middle lobe hyperplasia . Methods: Retrosymphysial urethred preserving prostatectomy conjunction with cystotomy has been carried out for 22 cases of Bph dealing with any in tracystic lesions at the same time . Results: All patients were operated successfully, After discharging from the hospital,the maximal uroflow rates is 14.0~24.5ml/s , the averages Ipss score is 4.5 , the residual urine is less than 20ml. All the patients have been follow up 3 to 30 months, satifactory result has been achieved . Conclusions: This technique not only excises the whole prostate, and protects the urethral mucosa from injury , but also deals with any intracyctic lesions at the same time . it's a better way to deal with the benign prostatic middle lobe hyperplasia.