经尿道前列腺电切联合膀胱颈内切开术治疗小体积前列腺增生的疗效观察

摘要

Objective To introduce an optimal treatment for bladder neck obstruction caused by small hyperplasia of prostate. Methods Study the 98 cases of small hyperplasia of prostate from January 2010 to April 2015 in our hospital for treatment. The observation group(anterior lobar reserved transurethral prostatectomy combined with incision of bladder neck)48 cases and the control group(transurethral prostatectomy)50 cases, mark two groups of patients before and after treatment. Results Following up 6 months,the prostate symptom scores(IPSS)、quality of life scores(QOL)、maximal flow rate(Qmax)of the observation group were better than the control group's,with statistical significance(P<0.001). 6 cases of bladder neck contracture(6/50)were found in the control group,and no cases of bladder neck contracture in the observation group (0/48),with statistical significance(P<0.05). There were 5 cases of postoperative urinary incontinence within one month after operation(5/50) and no case after one month in the control group,and no case after operation in the observation group(0/48),with no statistical significance (P>0.05).Conclusion Anterior lobar reserved transurethral prostatectomy combined with incision of bladder neck was proved to be ideal methods for management of patients with bladder neck obstruction caused by small hyperplasia of prostate. The methods has lower bladder neck contracture probability,should be widely applied.%目的：探讨小体积前列腺增生引起膀胱出口梗阻的理想手术方案。方法小体积前列腺增生患者98例。其中行保留前叶的经尿道前列腺电切联合膀胱颈内切开术48例（观察组），行经尿道前列腺等离子电切术50例（对照组）。比较两组患者的一般情况、术中术后及随访资料。结果观察组IPSS评分、QOL评分、Qmax均优于对照组，差异有统计学意义（P<0.01）。对照组出现6例膀胱颈挛缩，观察组无膀胱颈挛缩，差异有统计学意义（P<0.05）。观察组术后无尿失禁患者，对照组术后1个月内压力性尿失禁5例。结论保留前叶经尿道前列腺电切联合膀胱颈内切开术治疗小体积前列腺增生具有良好疗效，且发生膀胱颈挛缩可能性更低，值得推广应用。