Ramchandani P, Banner M P, Berlin J W, Dannenbaum M S, Wein A J
Department of Radiology, University of Pennsylvania Medical Center, Philadelphia 19104.
Radiology. 1994 Nov;193(2):345-9. doi: 10.1148/radiology.193.2.7972741.
To assess the efficacy of transurethral balloon dilation of vesicourethral anastomotic strictures after radical retropubic prostatectomy.
Forty-five consecutive patients in whom vesicourethral anastomotic strictures developed after radical prostatectomy underwent fluoroscopically guided transurethral balloon dilation (n = 27), cystoscopically guided transurethral incision of the bladder neck (n = 10), or dilation performed by urologists who used various techniques (n = 8).
Transurethral balloon dilation was successful in 16 (59%) of 27 patients. Ten of the 11 patients who did not respond favorably underwent transurethral incision of the bladder neck. Seven (70%) of these patients required either repeat attempts or subsequent balloon dilation. New urinary incontinence developed in one patient treated primarily with transurethral incision of the bladder neck but in no patients treated with transurethral balloon dilation.
Anastomotic strictures after radical prostatectomy can be effectively treated with transurethral balloon dilation with no serious complication. Refractoriness to balloon dilation may be related to the presence of dense scar tissue.
评估耻骨后根治性前列腺切除术后膀胱尿道吻合口狭窄行经尿道球囊扩张术的疗效。
45例前列腺根治术后出现膀胱尿道吻合口狭窄的患者，接受了荧光透视引导下的经尿道球囊扩张术（n = 27）、膀胱镜引导下的膀胱颈经尿道切开术（n = 10）或由使用各种技术的泌尿科医生进行的扩张术（n = 8）。
27例患者中16例（59%）经尿道球囊扩张术成功。11例反应不佳的患者中有10例行膀胱颈经尿道切开术。其中7例（70%）患者需要再次尝试或随后进行球囊扩张。1例主要接受膀胱颈经尿道切开术治疗的患者出现了新的尿失禁，而经尿道球囊扩张术治疗的患者未出现尿失禁。
耻骨后根治性前列腺切除术后的吻合口狭窄可通过经尿道球囊扩张术有效治疗，且无严重并发症。球囊扩张术治疗无效可能与致密瘢痕组织的存在有关。
