Mokos Ivica, Kastelan Zeljko, Basić-Jukić Nikolina, Kes Petar, Pasini Josip
University Department of Urology, Zagreb University Hospital Center, Zagreb, Croatia.
Acta Clin Croat. 2011 Sep;50(3):381-4.
The aim of the study was to assess the incidence and etiology of repeated bladder outlet obstruction (BOO) after kidney transplantation and to analyze the results of transurethral incision of the prostate/transurethral resection of the prostate (TUIP/TURP) in the early period after kidney transplantation. The study included 24 male patients having undergone renal transplantation and early transurethral surgery for BOO in our institution between 2005 and 2011. TUIP or TURP was performed depending on the etiology of BOO. The indications for transurethral surgery were repeated urinary retention despite therapeutic attempts with alpha-receptor antagonists, or repeated residual urine with renal transplant dysfunction and/or consequent urinary tract infection. Preoperative assessment included past medical history, clinical examination, PSA, volume of residual urine estimated with ultrasound, and urinary culture. Among 345 male patients having undergone renal transplantation, repeated BOO was noted in 24 patients. TUIP was performed in 19 and TURP in five patients. The mean age of our patients was 52 (range, 33-73) years and the mean time on dialysis 7.43 years (range, 4 months to 25 years). The procedure was performed on the mean of day 16 (range, 14-29) after transplantation and urethral catheter was removed on the mean of day 3.3 (range, 2-9) after the procedure. The etiology of BOO was bladder neck contracture in nine and benign prostatic hyperplasia in 15 patients. In all patients, surgical procedures were performed without any complication. Restoration of urinary bladder function was complete in all patients. In conclusion, early transurethral treatment of repeated BOO is a safe procedure with excellent results following renal transplantation.
本研究的目的是评估肾移植后反复膀胱出口梗阻（BOO）的发生率和病因，并分析肾移植术后早期经尿道前列腺切开术/经尿道前列腺切除术（TUIP/TURP）的结果。该研究纳入了2005年至2011年间在本机构接受肾移植并因BOO接受早期经尿道手术的24例男性患者。根据BOO的病因进行TUIP或TURP。经尿道手术的指征是尽管使用α受体拮抗剂进行了治疗尝试仍反复出现尿潴留，或反复出现残余尿伴肾移植功能障碍和/或随之而来的尿路感染。术前评估包括既往病史、临床检查、前列腺特异性抗原（PSA）、超声估计的残余尿量以及尿培养。在345例接受肾移植的男性患者中，有24例出现反复BOO。19例患者接受了TUIP，5例患者接受了TURP。我们患者的平均年龄为52岁（范围33 - 73岁），平均透析时间为7.43年（范围4个月至25年）。手术在移植后平均第16天（范围14 - 29天）进行，术后平均第3.3天（范围2 - 9天）拔除尿道导管。BOO的病因是膀胱颈挛缩9例，良性前列腺增生15例。所有患者手术过程均无任何并发症。所有患者膀胱功能均完全恢复。总之，肾移植后早期经尿道治疗反复BOO是一种安全的手术，效果良好。
