保护尿控功能技术在经尿道前列腺等离子剜除术中的应用体会

王德胜; 阴雷; 关超

doi:10.16766/j.cnki.issn.1674-4152.000780

保护尿控功能技术在经尿道前列腺等离子剜除术中的应用体会

doi: 10.16766/j.cnki.issn.1674-4152.000780

王德胜^1,2,
阴雷³,
关超^4, ,

1. 蚌埠医学院研究生院, 安徽蚌埠 233000;
2. 蚌埠市第二人民医院泌尿外科, 安徽蚌埠 233000;
3. 第二军医大学附属长征医院泌尿外科, 上海 200003;
4. 蚌埠医学院第二附属医院泌尿外科, 安徽蚌埠 233040

基金项目:

安徽省教育厅重点项目(KJ2018A0989)

详细信息

通讯作者:
关超,E-mail:13905526516@163.com

中图分类号: R697.32
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出版历程
- 收稿日期: 2018-09-21
- 网络出版日期: 2022-08-04

Experience of continence-preserving technique in transurethral plasmakinetic enucleation of the porstate

WANG De-sheng^1,2,
YIN Lei³,
GUAN Chao^{4
, ,}

Graduate School of Bengbu Medical College, Bengbu, Anhui 233000, China

摘要

摘要: 目的探讨经尿道前列腺等离子剜除术中采用改良保护尿控功能技术的临床效果及经验体会。方法回顾性分析2017年3月—2018年5月期间35例在蚌埠市第二人民医院接受保护尿控功能的改良经尿道前列腺等离子剜除术治疗患者的临床资料，术中应用保护尿控功能手术技术，观察患者术后拔除尿管后24 h、1周、1个月的尿失禁发生率，同时记录患者术前与术后3个月时的生活质量评分(score of quality of life,QOL)、国际前列腺症状评分(international prostate symptom score,IPSS)以及残余尿量(post-void residual,PVR)的变化并进行对比。结果患者平均手术时间为(90.6±45.2)min，切除前列腺组织体积为(66.3±32.2)mL，术中出血量为(42.5±10.5)mL，术后膀胱冲洗时间为(35.5±7.5)h，术后留置尿管时间为7 d，术后住院时间为(8.5±2.5)d。术中无出现电切综合征、无膀胱穿孔、无中转开放手术、无输血病例。统计拔除尿管24 h、1周、1个月时的尿失禁发生率分别为11.4%、2.8%、0.0%，较国内外文献统计报道的剜除术后尿失禁平均发生率(22.4%～43.1%)明显降低。术后随访3个月，排尿情况较术前有明显改善，生活质量评分(QOL)、国际前列腺症状评分(IPSS)以及残余尿量(PVR)均明显低于术前，差异有统计学意义(均P＜0.05)。结论采用保护尿控功能的改良前列腺等离子剜除术治疗良性前列腺增生患者，在取得良好手术效果的同时明显降低了术后尿失禁发生率，值得临床推广使用。
- 经尿道前列腺等离子剜除术 /
- 良性前列腺增生症 /
- 尿失禁
Abstract: Objective To assess the effect of continence-preserving technique in transurethral plasmakinetic enucleation of the porstate. Methods The clinical data of 35 patients who received modified transurethral plasmakinetic enucleation of prostate to protect urinary control function in Bengbu Second People's Hospital from March 2017 to May 2018 were retrospectively analyzed, and the technique of protecting urinary control function was applied during the operation. The incidence of urinary incontinence at 24 h after removal of the urinary catheter, 1 week and 1 month after operation were collected, and score of quality of life (QOL)， international prostate symptom score (IPSS) and post-void residual (PVR) before and 3 months after surgery were compared. Results The operation time was (90.6±45.2) min, the prostate tissue volume was (66.3±32.2) mL, the blood loss was (42.5±10.5) mL, the bladder irrigation time was (35.5±7.5) h, the catheter indwelling time was 7 days, and the postoperative hospital stay was (8.5±2.5) d. There were no cases of electrosurgical excision syndrome, no bladder perforation, no conversion to open surgery, and no blood transfusion. The average incidence of urinary incontinence in 35 patients at 24 h after removal of the urinary catheter, 1 week and 1 month after operation were 11.4%, 2.8% and 0.0% respectively, which were significantly lower than the average incidence of urinary incontinence (22.4%-43.1%) reported in literature. After 3 months of follow-up, urination was significantly improved compared with that before operation, the score of quality of life (QOL)， international prostate symptom score (IPSS) and post-void residual (PVR) also had significant difference between that before and after operation (all P＜0.05). Conclusion To treat benign prostatic hyperplasia patients with transurethral plasmakinetic enucleation of the porstate with improved continence-preserving technique showed better void in results and lower incidence of urinary incontinence after operation, which is worthy of clinical popularizing.
- Transurethral plasmakinetic enucleation of the porstate /
- Benign prostate hyperplasia /
- Urinary incontinence