论文部分内容阅读
目的探讨良性前列腺增生症(BPH)患者行经尿道前列腺电切术(TURP)后远期行二次TURP的原因及手术技巧。方法经TURP治疗的BPH患者1123例,其中54例行TURP后3~14年再次行TURP,分析54例患者的临床资料。结果 54例再次行TURP,术中电切镜下见膀胱颈挛缩10例,此类患者前列腺体积较小;前列腺腺体残留复发44例,其中两侧叶及中叶都增大者10例,两侧叶增大者15例,一侧叶或中叶增生明显者19例;并发膀胱结石7例。手术后随访,54例患者下尿路症状及血尿症状均消失或明显缓解。结论 BPH患者行二次TURP的原因多为腺体残留复发、膀胱颈挛缩及并发膀胱结石;手术时应尽量切除全部增生的组织,但也要避免切除过深而导致瘢痕形成。
Objective To investigate the causes and surgical techniques of secondary TURP after transurethral resection of prostate (TURP) in patients with benign prostatic hyperplasia (BPH). Methods A total of 1123 BPH patients undergoing TURP were enrolled. TURP was performed in 54 of 54 patients after TURP 3 to 14 years. The clinical data of 54 patients were analyzed. Results TURP was performed again in 54 cases. 10 cases of bladder neck contracture were seen under resectoscope during operation. Prostate volume in these patients was small. There were 44 cases of residual prostate gland recurrence, of which 10 cases had both sides lobe and middle lobe enlarged. There were 15 cases of increased lateral lobe, 19 cases of obvious side or middle lobe hyperplasia, and 7 cases complicated with bladder stone. Follow-up postoperatively, 54 cases of lower urinary tract symptoms and symptoms of hematuria disappeared or significantly alleviated. Conclusions The secondary TURP in BPH patients are mostly residual glandular recurrence, bladder neck contracture and complicated bladder stones. All the hyperplastic tissues should be resected during the operation, but scar removal should be avoided if the resection is too deep.