Gotoh M, Yoshikawa Y, Kondo A, Miyake K
Department of Urology, Hekinan Municipal Hospital.
Nihon Hinyokika Gakkai Zasshi. 1993 Jun;84(6):1041-5. doi: 10.5980/jpnjurol1989.84.1041.
Early and longterm results of transurethral incision of the prostate and bladder neck (TIPBn) were compared with those of transurethral resection of the prostate (TURP) in treatment of 36 patients with outflow obstruction caused by small benign prostatic hypertrophy. Seventeen patients underwent TIPBn and 19 TURP. Parameters on uroflowmetry (maximum flow rate, average flow rate, voiding time and residual rate) were significantly improved postoperatively in both groups. There was no significant difference in the improvement on uroflowmetry both at early (3 months) and longterm (TIPBn: 12-48, mean 20.1 months, TURP: 12-48, mean 22.2 months) postoperative periods, between the two groups. Subjective symptom of voiding difficulty was remarkably improved in all patients of both groups during early postoperative period. However, at longer follow-up, subjective improvement was preserved in 88.2% in the TIPBn group and 73.7% in the TURP group. A re-operation was needed in 4 cases (21.5%) in the TURP group because of recurrence of obstructive symptom due to postoperative bladder neck contracture, while a second operation has not been performed in the TIPBn group. We conclude that TIPBn can be the preferred surgical treatment of outflow obstruction caused by small benign prostatic hypertrophy.
对36例由小体积良性前列腺增生导致流出道梗阻的患者，比较经尿道前列腺及膀胱颈切开术（TIPBn）与经尿道前列腺切除术（TURP）的早期和长期结果。17例患者接受了TIPBn手术，19例接受了TURP手术。两组患者术后尿流率参数（最大尿流率、平均尿流率、排尿时间和残余尿量率）均有显著改善。两组在术后早期（3个月）和长期（TIPBn组：12 - 48个月，平均20.1个月；TURP组：12 - 48个月，平均22.2个月）尿流率改善方面无显著差异。两组所有患者术后早期排尿困难的主观症状均有显著改善。然而，在更长时间的随访中，TIPBn组88.2%的患者主观症状持续改善，TURP组为73.7%。TURP组有4例（21.5%）因术后膀胱颈挛缩导致梗阻症状复发而需要再次手术，而TIPBn组未进行二次手术。我们得出结论，TIPBn可作为小体积良性前列腺增生导致流出道梗阻的首选手术治疗方法。
