Dovlatian A A
Ter Arkh. 1993;65(6):68-72.
Basing on the analysis of 136 urgent radical surgeries for acute retention of urine in prostatic adenoma patients, the author specifies indications for immediate and delayed adenomectomies. These were combined in a group of urgent adenomectomies because they were not preceded with cystostomy, being performed in one-stage for acute urologic disorders. Immediate operations (36.1%) were conducted within 3 post-admission days unless radical surgery was contraindicated. Delayed operations (63.9%) needed preoperative drug correction of complicating disorders, mainly cardiovascular. The operative risk arose due to complications of the adenoma itself, urological and cardiovascular diseases. Among the latter cardiac and cerebral ischemia occurred most commonly. It was proved useful to drain the bladder with a permanent urethral catheter when preparing patients for delayed adenomectomy. High efficacy (91.9%) of urgent adenomectomy for acute retention of urine in preexisting somatic diseases suggests its significant practical value.
基于对136例前列腺腺瘤患者急性尿潴留急诊根治性手术的分析，作者明确了即刻和延迟前列腺切除术的适应证。这些手术被归为急诊前列腺切除术组，因为它们未先行膀胱造瘘术，而是针对急性泌尿系统疾病一期完成。除非有根治性手术禁忌证，即刻手术（36.1%）在入院后3天内进行。延迟手术（63.9%）需要对合并症进行术前药物治疗，主要是心血管方面的合并症。手术风险源于腺瘤本身、泌尿系统和心血管疾病的并发症。其中，心脏和脑缺血最为常见。事实证明，在为延迟前列腺切除术患者做准备时，使用永久性尿道导管引流膀胱是有用的。急诊前列腺切除术对已有躯体疾病患者的急性尿潴留疗效显著（91.9%），表明其具有重要的实际价值。
