Liao Jie, Zhang Xiaobo, Chen Mingquan, Li Dongjie, Tan Xinji, Gu Jie, Hu Sheng, Chen Xiong
Department of Geriatric Medicine, Xiang Ya Hospital, Central South University, Changsha, China.
International Medical Center, Xiang Ya Hospital, Central South University, Changsha, China.
Wideochir Inne Tech Maloinwazyjne. 2019 Jan;14(1):96-101. doi: 10.5114/wiitm.2018.79536. Epub 2018 Nov 14.
Even though transurethral resection of the prostate (TURP) is the standard surgical treatment for benign prostatic hyperplasia (BPH), there is a high rate of postoperative retrograde ejaculation.
To evaluate the effectiveness of TURP with preservation of the bladder neck in comparison with that of standard TURP.
This is a retrospective study. 137 men with BPH were divided into two groups: TURP with preservation of the bladder neck and standard TURP were performed respectively in group A and group B. The patients were evaluated preoperatively and at 3, 6 and 12 months after surgery by International Prostate Symptom Score (IPSS), health-related quality of life (HRQL) score, maximum urinary flow rate (Qmax), postvoid residual urine volume (PVR) and the rate of complications including retrograde ejaculation.
There was no statistically significant difference between groups in terms of the operative duration, catheterization period, hemoglobin decrease, and hospital stay. At the 3-month follow-up, the rates of incontinence and retrograde ejaculation in group A were lower than those in group B. At the 6- and 12-month follow-ups, the difference in the frequency of retrograde ejaculation remained constantly stable whereas the incontinence rates were similar in both groups. The IPSS, HRQL score, Qmax, PVR and the rate of complications including hematuria, clot retention, urinary tract infection, urethral stricture, and bladder neck contracture evaluated at 3, 6 and 12 months also displayed a very similar response in the two groups.
Comparable with standard TURP, TURP with preservation of the bladder neck appears to provide a satisfactory clinical outcome in decreasing early postoperative incontinence and lowering the rate of retrograde ejaculation.
尽管经尿道前列腺切除术（TURP）是良性前列腺增生（BPH）的标准外科治疗方法，但术后逆行射精的发生率很高。
评估保留膀胱颈的TURP与标准TURP相比的有效性。
这是一项回顾性研究。137例BPH男性患者分为两组：A组和B组分别进行保留膀胱颈的TURP和标准TURP。术前以及术后3、6和12个月通过国际前列腺症状评分（IPSS）、健康相关生活质量（HRQL）评分、最大尿流率（Qmax）、排尿后残余尿量（PVR）以及包括逆行射精在内的并发症发生率对患者进行评估。
两组在手术时间、导尿时间、血红蛋白下降情况和住院时间方面无统计学显著差异。在3个月的随访中，A组的尿失禁和逆行射精发生率低于B组。在6个月和12个月的随访中，逆行射精频率的差异持续稳定，而两组的尿失禁发生率相似。在3、6和12个月时评估的IPSS、HRQL评分、Qmax、PVR以及包括血尿、血块潴留、尿路感染、尿道狭窄和膀胱颈挛缩在内的并发症发生率在两组中也显示出非常相似的反应。
与标准TURP相比，保留膀胱颈的TURP在降低术后早期尿失禁和降低逆行射精发生率方面似乎能提供令人满意的临床结果。
