Gotoh M, Tsuji Y, Nagai T, Kato K, Kondo A, Miyake K
Department of Urology, Hekinan Municipal Hospital.
Nihon Hinyokika Gakkai Zasshi. 1990 Sep;81(9):1372-8. doi: 10.5980/jpnjurol1989.81.1372.
Transurethral incision of the prostate and bladder neck (TIPBn) was compared with transurethral resection of the prostate (TURP) followed by bladder neck incision in the treatment of 22 patients with outflow obstruction caused by a small prostate adenoma (below 15 gm). Eleven patients underwent TIPBn and another 11 TURP. An evaluation of the urodynamic findings and subjective symptoms was undertaken before the operation and 3 months afterwards. Urodynamic findings were evaluated, based upon uroflowmetry, i.e., in terms of maximum flow rate, average flow rate, voiding time, initiation time and residual rate. All patients in the TIPBn group revealed an improvement in every urodynamic parameter (MFR: from 6.1 to 10.8 ml/sec, AFR: from 3.1 to 5.8 ml/sec, Voiding time: from 95.5 to 24.2 sec/100 ml, Initiation time: 34.3 to 10.2 sec, Residual rate: 31.6 to 17.8%, in mean value). Ten out of the 11 in the TIPBn group subjectively considered the result to be good. The improvements in the urodynamic parameters in the TIPBn group were statistically comparable to those in the TURP. The improvements in voiding time and initiation time, however, tended to be much better in the TIPBn group. We conclude that TIPBn can be the operation of choice in the treatment of outflow obstruction caused by a small prostate.
对22例因小前列腺腺瘤（重量小于15克）导致排尿梗阻的患者，比较经尿道前列腺及膀胱颈切开术（TIPBn）与经尿道前列腺切除术（TURP）加膀胱颈切开术的疗效。11例患者接受TIPBn手术，另11例接受TURP手术。在术前及术后3个月对尿动力学检查结果和主观症状进行评估。根据尿流率对尿动力学检查结果进行评估，即最大尿流率、平均尿流率、排尿时间、启动时间和残余尿量率。TIPBn组所有患者的各项尿动力学参数均有改善（平均最大尿流率：从6.1毫升/秒增至10.8毫升/秒，平均尿流率：从3.1毫升/秒增至5.8毫升/秒，排尿时间：从95.5秒/100毫升降至24.2秒/100毫升，启动时间：从34.3秒降至10.2秒，残余尿量率：从31.6%降至17.8%）。TIPBn组11例患者中有10例主观认为效果良好。TIPBn组尿动力学参数的改善在统计学上与TURP组相当。然而，TIPBn组排尿时间和启动时间的改善趋势要好得多。我们得出结论，TIPBn可作为治疗小前列腺引起的排尿梗阻的首选手术。
