Takeda M, Takahashi H, Tsutsui T, Go H, Hatano A, Komeyama T, Tamaki M, Saito K, Sato S, Sasagawa T
Department of Urology, Niigata University School of Medicine.
Nihon Hinyokika Gakkai Zasshi. 1993 Sep;84(9):1595-601. doi: 10.5980/jpnjurol1989.84.1595.
Intraurethral catheters (IUC) were used for elderly male patients with prostatic urethral obstruction (PUO) due to malignancy (MA) and benign prostatic hypertrophy (BPH). Thirty-three men complaining of urinary retention in spite of medical therapy at the risk for prostatic surgery underwent insertion of IUC (16Fr Puroflex, Angiomed Co., Ltd., Germany). Six of 33 were patients with PUO due to MA (5 prostatic cancer, and 1 urethral invasion of rectal cancer, mean 82.7 years old), and the other 27 were patients with BPH (average 80.1 years old). Follow-up period of the former ranged from 2 to 9 (mean 6.5) months, and that of the latter ranged from 6 to 23 months. Water filling cystometry (CMG) before the insertion of IUC and fluoroscopic voiding cystourethrography (VCU) just after insertion of IUC were performed. We defined normal CMG and normal VCU as normal bladder, overactive CMG and normal VCU as overactive bladder, and normal or poor sensitive CMG and underactive VCU as underactive bladder. Five of 27 BPH patients had previous prostatic operations (TUR-P, and/or balloon dilation), but 6 MA did not. All of MA (3 normal bladder, 2 overactive bladder, and 1 underactive bladder) voided satisfactorily, and average duration of IUC in place was 6.5 months without exchange of IUC. Although sixteen of 27 (59.3%) BPH patients voided satisfactorily, and average duration of IUC in place was 12.1 months without exchange of IUC, in the other 11 of these 27 BPH patients were removed IUC, and average duration of IUC in place was 4.7 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)
尿道内导管(IUC)用于因恶性肿瘤(MA)和良性前列腺增生(BPH)导致前列腺尿道梗阻(PUO)的老年男性患者。33名尽管接受了药物治疗但仍有尿潴留且有前列腺手术风险的男性接受了IUC插入(16Fr Puroflex,德国Angiomed有限公司)。33例中有6例是因MA导致PUO的患者(5例前列腺癌,1例直肠癌尿道侵犯,平均年龄82.7岁),另外27例是BPH患者(平均年龄80.1岁)。前者的随访期为2至9(平均6.5)个月,后者为6至23个月。在插入IUC前进行了注水膀胱测压(CMG),插入IUC后立即进行了荧光透视排尿膀胱尿道造影(VCU)。我们将正常CMG和正常VCU定义为正常膀胱,过度活跃CMG和正常VCU定义为膀胱过度活动症,正常或敏感性差的CMG和排尿功能减退的VCU定义为排尿功能减退的膀胱。27例BPH患者中有5例曾接受过前列腺手术(经尿道前列腺切除术和/或球囊扩张术),但6例MA患者没有。所有MA患者(3例正常膀胱,2例膀胱过度活动症,1例排尿功能减退的膀胱)排尿满意,IUC留置的平均时间为6.5个月,无需更换IUC。虽然27例BPH患者中有16例(59.3%)排尿满意,IUC留置的平均时间为12.1个月,无需更换IUC,但这27例BPH患者中的另外11例被拔除了IUC,IUC留置的平均时间为4.7周。(摘要截短至250字)