Bao Ji-Ming, Tan Wan-Long, Wang Bing-Wei, Qiu Xiao-Fu, Liu Bai-Chuan, Zhong Rui-Lun, Li Gao-Yuan, Yang Guo-Sheng
Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
Department of Urology, Guangdong No. 2 Provincial People's Hospital, Southern Medical University, Guangzhou, 510317, China.
Int Urol Nephrol. 2016 Apr;48(4):475-80. doi: 10.1007/s11255-015-1209-4. Epub 2016 Jan 23.
To describe a novel transurethral front-firing Greenlight bladder autoaugmentation for the treatment of bladder contracture and report initial clinical outcomes.
Between April 2014 and August 2015, five patients diagnosed with contracted bladder were all refractory to conservative treatment and received novel transurethral autoaugmentation. CT scan and urodynamics examination were conducted before operation for disease assessment. Mucosal and muscular layers of bladder wall in fundus were incised vertically and horizontally with front-firing Greenlight laser to enlarge bladder capacity in the operation. Imaging examination and periodical urodynamics study were performed to evaluate the clinical outcomes of the procedure in postoperative follow-up.
Transurethral front-firing Greenlight bladder autoaugmentation was performed successfully on all the patients. The mean operative time was 59 min (range 52-65 min) with no significant blood loss. Urodynamic parameters of these patients after operation improved significantly compared with those before operation. Average maximum cystometric capacity (Vmax) increased from 91.2 to 333 ml (p < 0.01), average maximum flow rate (Qmax) ascended from 12.6 to 18.62 ml/min (p < 0.01), and average flow rate (Q(ave)) also increased from 5.74 to 13.18 ml/min (p < 0.01). At the last follow-up, all the patients could void spontaneously with good bladder emptying and their symptoms improved significantly.
Our novel transurethral front-firing Greenlight bladder autoaugmentation is a safe and effective treatment for contracted bladders. Future studies with larger sample size and long-term follow-up are needed to confirm our findings.
描述一种用于治疗膀胱挛缩的新型经尿道前向发射绿激光膀胱自体扩大术，并报告初步临床结果。
2014年4月至2015年8月期间，5例诊断为膀胱挛缩的患者均对保守治疗无效，接受了新型经尿道自体扩大术。术前进行CT扫描和尿动力学检查以评估病情。术中使用前向发射绿激光在膀胱底部垂直和水平切开膀胱壁的黏膜和肌层以扩大膀胱容量。术后随访期间进行影像学检查和定期尿动力学研究以评估该手术的临床效果。
所有患者均成功进行了经尿道前向发射绿激光膀胱自体扩大术。平均手术时间为59分钟（范围52 - 65分钟），无明显失血。这些患者术后的尿动力学参数与术前相比有显著改善。平均最大膀胱测压容量（Vmax）从91.2毫升增加到333毫升（p < 0.01）；平均最大尿流率（Qmax）从12.6毫升/分钟升至18.62毫升/分钟（p < 0.01）；平均尿流率（Q(ave)）也从5.74毫升/分钟增加到13.18毫升/分钟（p < 0.01）。在最后一次随访时，所有患者均能自主排尿，膀胱排空良好，症状明显改善。
我们的新型经尿道前向发射绿激光膀胱自体扩大术是治疗膀胱挛缩的一种安全有效的方法。需要进一步开展更大样本量和长期随访研究以证实我们的发现。
