Surya B V, Provet J, Johanson K E, Brown J
Urology Service, Department of Veterans Affairs Medical Center, New York, New York.
J Urol. 1990 Apr;143(4):755-8. doi: 10.1016/s0022-5347(17)40082-6.
Stricture of the anastomosis between the bladder neck and membranous urethra after radical prostatectomy can cause significant voiding dysfunction. Of 156 patients undergoing radical prostatectomy for localized prostatic carcinoma 18 had anastomotic stricture for an over-all incidence of 11.5%. The risk factors for anastomotic stricture and the treatment outcome in these patients were analyzed. Excessive intraoperative blood loss, extravasation of urine at the anastomotic site and a prior transurethral prostatic operation significantly contributed to the development of stricture. More than half of the patients did not respond to simple dilation alone. Cold knife incision of the stricture by itself was effective in only 62% of the patients. The remaining patients required periodic dilation to maintain an adequate urine flow. Incision of the stricture with electrocautery resulted in urinary incontinence in all patients.
根治性前列腺切除术后膀胱颈与膜部尿道吻合口狭窄可导致严重的排尿功能障碍。在156例因局限性前列腺癌接受根治性前列腺切除术的患者中，有18例出现吻合口狭窄，总体发生率为11.5%。分析了这些患者吻合口狭窄的危险因素及治疗结果。术中失血过多、吻合口处尿液外渗以及既往经尿道前列腺手术均显著促成狭窄的发生。超过半数的患者仅单纯扩张治疗无效。单纯冷刀切开狭窄仅对62%的患者有效。其余患者需要定期扩张以维持足够的尿流。电灼切开狭窄导致所有患者出现尿失禁。
