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使用针型电极三点经尿道膀胱颈切开术治疗膀胱颈挛缩

Transurethral Incision of the Bladder Neck at Three Points with a Needle-Type Electrode for Bladder Neck Contracture.

作者信息

Cao Guihua, Liu Liangcheng, Du Jianping, Li Wei, Li Qiang, Luo Na, Liu Xun, Zhou Junjie, Wu Tao

机构信息

Department of Urology, People's Hospital of Leshan, Leshan, China.

Department of Pathology, People's Hospital of Leshan, Leshan, China.

出版信息

Front Surg. 2022 May 9;9:871099. doi: 10.3389/fsurg.2022.871099. eCollection 2022.

Abstract

PURPOSE

This study aims to evaluate the efficacy of transurethral incision of the bladder neck (TUIBN) at three points with a needle-type electrode for treatment of bladder neck contracture (BNC).

MATERIALS AND METHODS

Between January 2016 and April 2021, the bladder necks of 53 patients with BNC after surgery were incised by the needle-type electrode at the 5, 7, and 12 O'clock positions. Patient's preoperational characteristics, peri- and postsurgical outcomes, such as time of operation, postoperative bladder irrigation, and postoperative hospital stay, and data of the international prostate symptom score (IPSS), maximum flow rate (Qmax), and postvoid residual (PVR) were recorded 3 and 6 months after surgery.

RESULTS

All 53 cases of BNC were successfully treated in 35.00 (25.00, 45.00) min with 18.00 (14.00, 21.00) h for postoperative bladder irrigation with little intraoperative bleeding (less than 50 mL). The postoperative hospital stay ranged from 2 to 8 days, a mean of 3.50 (3.00, 5.00) days. No major intraoperative or postoperative complications were observed. All cases that underwent follow-up assessment at 3 and 6 months after the surgery showed significantly decreased IPSS and PVR and increased Qmax compared to preoperation ones ( ≤ 0.001). Of these 53 patients, there was no recurrence in severe BNC patients, but 5 of 53 (9.4%) BNC patients developed BNC again within 6 months and required repeated TUIBN. Thirty patients comprised five recurrent cases with a follow-up period of more than 1 year.

CONCLUSIONS

TUIBN at three points provides a safe, effective, and reliable option in treating patients with BNC.

摘要

目的

本研究旨在评估采用针型电极在三个点行经尿道膀胱颈切开术(TUIBN)治疗膀胱颈挛缩(BNC)的疗效。

材料与方法

2016年1月至2021年4月,对53例术后发生BNC的患者,采用针型电极于膀胱颈的5点、7点和12点位置进行切开。记录患者的术前特征、围手术期和术后结果,如手术时间、术后膀胱冲洗时间和术后住院时间,以及术后3个月和6个月时的国际前列腺症状评分(IPSS)、最大尿流率(Qmax)和残余尿量(PVR)数据。

结果

53例BNC患者均成功接受手术,手术时间为35.00(25.00,45.00)分钟,术后膀胱冲洗时间为18.00(14.00,21.00)小时,术中出血少(少于50 mL)。术后住院时间为2至8天,平均为3.50(3.00,5.00)天。未观察到严重的术中或术后并发症。所有在术后3个月和6个月接受随访评估的病例,与术前相比,IPSS和PVR均显著降低,Qmax升高(P≤0.001)。在这53例患者中,重度BNC患者无复发,但53例(9.4%)BNC患者中有5例在6个月内再次发生BNC,需要再次行TUIBN。30例患者包括5例复发病例,随访期超过1年。

结论

三点TUIBN为治疗BNC患者提供了一种安全、有效且可靠的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe6a/9125029/56138f33b7c2/fsurg-09-871099-g001.jpg

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