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经尿道前列腺切除术后泌尿系统症状的3年随访

3-year followup of urinary symptoms after transurethral resection of the prostate.

作者信息

Bruskewitz R C, Larsen E H, Madsen P O, Dørflinger T

出版信息

J Urol. 1986 Sep;136(3):613-5. doi: 10.1016/s0022-5347(17)44991-3.

Abstract

A total of 84 patients underwent detailed symptom analysis and urodynamic study preoperatively, and 3 and 12 months after transurethral resection of the prostate. In addition, 69 patients were contacted 3 years postoperatively for a detailed symptom analysis. These 3-year data then were compared to earlier evaluations. At 3 years 75 per cent of the patients claimed to have improvement, while 13 per cent stated that they were the same symptomatically. At the 1-year evaluation 84 per cent of the patients believed that they were improved and 10 per cent stated that they were unchanged. At 3 years 18 per cent of the patients had urge incontinence (an increase from 6 per cent at 1 year), while none complained of marked nocturia or frequency. Mean total irritative and obstructive symptoms were minimal and unchanged from the 1-year evaluation. Of the patients 33 per cent noticed decreased or absent erections and most blamed the surgery. One patient required another prostatic resection, while stricture developed in 3 and bladder neck contracture occurred in 6. We conclude that prostatic resection results in reasonable 3-year symptomatic improvement but it is hampered by other complications, including bladder neck contracture and, possibly, impotence.

摘要

共有84例患者在经尿道前列腺切除术前、术后3个月和12个月进行了详细的症状分析和尿动力学研究。此外,在术后3年对69例患者进行了联系,以进行详细的症状分析。然后将这些3年的数据与早期评估进行比较。3年后,75%的患者声称病情有所改善,而13%的患者表示症状没有变化。在1年的评估中,84%的患者认为病情有所改善,10%的患者表示病情没有变化。3年后,18%的患者出现急迫性尿失禁(从1年时的6%有所增加),而没有人抱怨明显的夜尿症或尿频。总的刺激性和梗阻性症状的平均值最小,与1年评估时相比没有变化。33%的患者注意到勃起功能减退或消失,大多数人将其归咎于手术。1例患者需要再次进行前列腺切除术,3例出现尿道狭窄,6例发生膀胱颈挛缩。我们得出结论,前列腺切除术在3年时能带来合理的症状改善,但会受到其他并发症的影响,包括膀胱颈挛缩以及可能的阳痿。

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