Vicente J, Salvador J, Chéchile G
Department of Urology, Puigvert Foundation, Barcelona, Spain.
J Urol. 1989 Dec;142(6):1504-6. doi: 10.1016/s0022-5347(17)39140-1.
A spiral urethral prosthesis was inserted with use of local anesthesia in 22 patients with benign prostatic hyperplasia who had long-term indwelling bladder catheters (mean 13 months) and anesthetic contraindications to an operation (American Society of Anesthesiologists rating of 4 in 86% of the patients). Of the 22 patients 7 (31.8%) did not reach 12 months of followup for different reasons. The remaining 15 patients were followed with clinical evaluations, urine cultures, transrectal ultrasound, voiding urethrography and urine flow rates at 3, 6 and 12 months. Final evaluation at 12 months showed normal voiding in 74% of the patients with an absence of significant post-void residual in all. In 10 patients (67%) urinary flow rates varied between 6 and 14 cc per second and in the remaining it was less than 6 cc per second. In 60% of the patients urine culture was negative. Our results suggest that a spiral urethral prosthesis, placed with the patient under local anesthesia, is an excellent substitute for long-term, indwelling, bladder catheterization, and is a useful alternative to an operation in patients with an increased surgical risk.
对22例良性前列腺增生患者在局部麻醉下插入螺旋尿道假体，这些患者长期留置膀胱导管（平均13个月）且存在手术麻醉禁忌（86%的患者美国麻醉医师协会分级为4级）。22例患者中，7例（31.8%）因不同原因未达到12个月的随访。其余15例患者在3个月、6个月和12个月时进行临床评估、尿培养、经直肠超声、排尿尿道造影和尿流率检查。12个月时的最终评估显示，74%的患者排尿正常，均无明显的残余尿量。10例患者（67%）的尿流率在每秒6至14毫升之间，其余患者的尿流率小于每秒6毫升。60%的患者尿培养为阴性。我们的结果表明，在局部麻醉下为患者置入螺旋尿道假体，是长期留置膀胱导管的极佳替代方法，也是手术风险增加患者的一种有用的手术替代方案。
