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预测经尿道双极前列腺切除术(TURP)后尿道狭窄发展的因素。

Factors predicting the development of urethral stricture after bipolar transurethral resection of the prostate.

机构信息

Lokman Hekim University, Faculty of Medicine, Department of Urology - Ankara, Turkey.

出版信息

Rev Assoc Med Bras (1992). 2022 Jan;68(1):50-55. doi: 10.1590/1806-9282.20210550.

Abstract

OBJECTIVE

We aimed to investigate the rate of urethral stricture development, predictor factors, and the reliability following bipolar transurethral resection of the prostate.

METHODS

A total of 124 patients participated in this study. Patient data were retrospectively reviewed. The patients were divided into group 1 (those who developed urethral stricture) and group 2 (those who did not develop urethral stricture). Annual checkups were performed after the postoperative months 1 and 6. The patients were checked by uroflowmetry + post-voiding residue and international index of erectile function. We evaluated the complications that developed during the perioperative period according to the Clavien system.

RESULTS

Urethral stricture developed in 10.5% (13/124) of the patients. It was found that patients who underwent transurethral resection of the prostate for the second time (p=0.007), patients with a preoperative catheter or history of catheter insertion (p=0.009), patients with high preoperative median white blood cell (103) counts (p=0.013), and patients with long postoperative catheterization time had a higher rate of urethral stricture after bipolar transurethral resection of the prostate (p=0.046). No grade 4 and grade 5 complications were observed according to the Clavien system in patients.

CONCLUSION

Factors such as second transurethral resection of the prostate surgery, history of preoperative catheter insertion, high postoperative white blood cell count, and long postoperative catheterization time increase the risk of urethral stricture after bipolar transurethral resection of the prostate.

摘要

目的

我们旨在研究经尿道前列腺双极电切术后尿道狭窄的发生率、预测因素及可靠性。

方法

共有 124 例患者参与本研究。回顾性分析患者资料。将患者分为 1 组(发生尿道狭窄)和 2 组(未发生尿道狭窄)。术后第 1 个月和第 6 个月进行年度检查。通过尿流率+残余尿量和国际勃起功能指数检查对患者进行检查。根据 Clavien 系统评估围手术期发生的并发症。

结果

10.5%(13/124)的患者发生尿道狭窄。发现第二次行经尿道前列腺电切术的患者(p=0.007)、术前有留置导尿管或有留置导尿管史的患者(p=0.009)、术前白细胞中位数高(103)的患者(p=0.013)和术后留置导尿管时间较长的患者,经尿道前列腺双极电切术后发生尿道狭窄的风险更高(p=0.046)。根据 Clavien 系统,患者未观察到 4 级和 5 级并发症。

结论

经尿道前列腺双极电切术后再次手术、术前留置导尿管史、术后白细胞计数高和术后留置导尿管时间长等因素会增加尿道狭窄的风险。

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