Klarskov P, Holm-Bentzen M, Larsen S, Gerstenberg T, Hald T
Department of Urology, Herlev Hospital, University of Copenhagen, Denmark.
Scand J Urol Nephrol. 1988;22(4):251-6. doi: 10.3109/00365598809180795.
Partial cystectomy was performed for myogenic decompensated bladder with excessive residual urine in 11 patients, in whom training instructions and pharmacological treatment were unsuccessful. Postoperatively, the patients were followed for 2-13 years (median 4 years). Both symptoms and residual urine were reduced permanently. Urodynamic testing had demonstrated underactive detrusor function in all. The supposed etiology was infravesical obstruction in 4, overdistension due to sensory bladder paresis in 3 and unknown in 4. Histological examination of the resected bladders showed focal degeneration of the smooth muscle cells (detrusor myopathy) in 7, transmural edema and vast deposits of collagen in 8, mastocytosis in 3 and eosinophilic cystitis in 1. In conclusion we regard partial cystectomy an alternative to clean intermittent self-catheterization in selected patients with excessive residual urine.
对11例因肌源性失代偿膀胱伴残余尿量过多且训练指导和药物治疗无效的患者实施了部分膀胱切除术。术后对患者进行了2至13年的随访（中位时间为4年）。症状和残余尿量均永久性减少。尿动力学检查显示所有患者逼尿肌功能低下。推测的病因是膀胱颈以下梗阻4例，感觉性膀胱麻痹导致膀胱过度扩张3例，病因不明4例。切除膀胱的组织学检查显示，7例有平滑肌细胞局灶性变性（逼尿肌肌病），8例有透壁水肿和大量胶原沉积，3例有肥大细胞增多症，1例有嗜酸性膀胱炎。总之，我们认为部分膀胱切除术是部分残余尿量过多的特定患者清洁间歇性自我导尿的一种替代方法。
