Ngan J H, Lau J L, Lim S T, Chan K W, Tam P C, Li M K
Department of Surgery, University of Hong Kong, Queen Mary Hospital.
J Urol. 1993 Apr;149(4):731-4. doi: 10.1016/s0022-5347(17)36194-3.
Long-term results of gastrocystoplasty had not been reported in the literature. The results of 10 patients (7 augmentation and 3 replacement) during 15 years were reviewed. All patients voided spontaneously and achieved daytime continence. Enuresis occurred in 3 patients. Median peak flow rate and post-void residual urine were 16.0 ml. per second and 10 ml., respectively. Average cystometric capacity was 554 ml. and median pressure at full capacity was 46 cm. water. Phasic contractions resulted in pressures higher than 50 cm. water in 4 patients. Small capacity, absence of bladder sensation and high pressure were identified as risk factors for a poor result. Routine urine culture was positive in 20.5%. Urine mucus content remained low. Electrolyte disturbance, histopathological abnormalities and ulcer syndrome related to hypergastrinemia were absent. The data showed that antral gastrocystoplasty is superior because of the low infective complication rate, ability to empty and absence of metabolic disturbance.
胃膀胱扩大成形术的长期结果在文献中尚未见报道。回顾了15年间10例患者(7例行扩大术,3例行替代术)的结果。所有患者均能自主排尿,白天保持干爽。3例患者出现遗尿。平均最大尿流率和排尿后残余尿量分别为每秒16.0毫升和10毫升。平均膀胱容量为554毫升,最大容量时的平均压力为46厘米水柱。4例患者出现相位性收缩,压力高于50厘米水柱。小容量、无膀胱感觉和高压被确定为预后不良的危险因素。常规尿培养阳性率为20.5%。尿液黏液含量保持较低水平。未出现电解质紊乱、组织病理学异常及与高胃泌素血症相关的溃疡综合征。数据表明,胃窦膀胱扩大成形术具有优势,因为其感染并发症发生率低、有排空能力且无代谢紊乱。