TURP联合经尿道膀胱颈切开术治疗小体积前列腺增生所致膀胱出口梗阻的疗效分析

目的:探讨经尿道前列腺电切术(TURP)联合经尿道膀胱颈切开术(TUIBN)治疗小体积前列腺增生(BPH)所致膀胱出口梗阻的疗效。方法:选择2009年1月~2013年12月我院收治的小体积BPH患者,其中单纯经尿道前列腺电切术(TURP组)48例,经尿道前列腺电切术联合经尿道膀胱颈切开术(TURP+TUIBN组)48例。比较两组的术前、术后国际前列腺症状评分(IPSS)、残余尿量(PVR)、最大尿流率(Qmax)等,以及术后并发症的发生情况。结果:TURP+TUIBN组术中出血量较TURP组明显增多(P0.05),两组手术时间、组织切除质量比较,差异均无统计学意义(P0.05);与TURP组比较,TURP+TUIBN组术后6个月IPSS评分、PVR明显下降,Qmax、膀胱压力明显上升(P0.05);TURP+TUIBN组并发症发生率为4.2%,显著低于TURP组16.7%(P0.05)。结论:TURP+TUIBN治疗小体积前BPH所致膀胱出口梗阻,可彻底切除增生腺体,消除小体积BPH的各种梗阻因素,减少术后膀胱颈挛缩的发生。

Clinical Effect of TURP Combined with TUIBN for Bladder Outlet Obstruction Caused by Small-size Benign Prostatic Hyperplasia

Objective:To explore the effect of transurethral resection of prostate (TURP) combined with transurethral incision of the bladder neck (TUIBN) for bladder outlet obstruction caused by small-size benign prostatic hyperplasia (BPH).Methods:98 patients with small-size BPH who received treatment in our hospital from January 2009 to December 2013 were included. All the cases were treated by TURP+ TUIBN and TURP, respectively. The international prostate symptom score(IPSS), maximum urinary flow rate (Qmax) and postvoid residual urine volume(PVR), bladder neck contracture were compared between the two groups.Results:The blood loss during operation were significantly lower in TURP group than that in TURP+ TUIBN group (P<0.05), while there were no significant difference on operation time andprostatic tissues resected (P>0.05). Compared wih TURP group, the IPSS score, PVR reduced, Qmax, and bladder pressure increased in TURP+ TUIBN group (P<0.05). The incidence of complications in TURP+ TUIBN group (4.2%) was significantly lower than that in TURP group (16.7%) (P<0.05).Conclusion:TURP combined with TUIBN for bladder outlet obstruction caused by small-size BPH, can remove completely hyperplasia gland, eliminate all the obstruction factors of BPH, and reduce the occurrence of postoperative bladder neck contracture.