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梗阻解除手术后良性前列腺增生所致膀胱肥大的可逆性改变。

Reversible change of bladder hypertrophy due to benign prostatic hyperplasia after surgical relief of obstruction.

作者信息

Kojima M, Inui E, Ochiai A, Naya Y, Kamoi K, Ukimura O, Watanabe H

机构信息

Department of Urology, Kyoto Prefectural University of Medicine, Japan.

出版信息

J Urol. 1997 Jul;158(1):89-93. doi: 10.1097/00005392-199707000-00024.

Abstract

PURPOSE

Ultrasound estimated bladder weight was compared before and after surgery for benign prostatic hyperplasia (BPH) to reveal a possible reversible change in bladder hypertrophy.

MATERIALS AND METHODS

Ultrasound estimated bladder weight was measured before and after subcapsular (17) or transurethral (16) prostatectomy in 33 male patients with BPH. Sequential changes in the American Urological Association symptom score and urinary flow rate were also examined.

RESULTS

Along with a significant improvement in the American Urological Association symptom scores and maximum flow rate, ultrasound estimated bladder weight decreased from 52.9 +/- 22.6 to 31.6 +/- 15.8 gm. in 12 weeks after treatment. In all but 4 patients (29 of 33, or 87.9%) ultrasound estimated bladder weight decreased to less than 35.0 gm. in 12 weeks after treatment. Interestingly, in all patients with an initial ultrasound estimated bladder weight of greater than 80 gm. the bladder weight still remained at an abnormally high level 12 weeks after treatment.

CONCLUSIONS

Bladder hypertrophy was completely reversible after the surgical treatment of the obstruction in the majority of patients with BPH. The measurement of ultrasound estimated bladder weight was of value in monitoring therapeutic effects in BPH patients. An extraordinarily high ultrasound estimated bladder weight of 80 gm. or more might suggest degenerative and irreversible pathological changes in the bladder detrusor.

摘要

目的

比较良性前列腺增生(BPH)手术前后超声估算的膀胱重量,以揭示膀胱肥大可能的可逆性变化。

材料与方法

对33例BPH男性患者在进行包膜下(17例)或经尿道(16例)前列腺切除术前及术后测量超声估算的膀胱重量。还检查了美国泌尿外科学会症状评分和尿流率的连续变化。

结果

随着美国泌尿外科学会症状评分和最大尿流率的显著改善,治疗后12周超声估算的膀胱重量从52.9±22.6克降至31.6±15.8克。除4例患者外(33例中的29例,即87.9%),治疗后12周超声估算的膀胱重量降至35.0克以下。有趣的是,所有初始超声估算膀胱重量大于80克的患者,治疗后12周膀胱重量仍处于异常高水平。

结论

在大多数BPH患者中,梗阻手术治疗后膀胱肥大是完全可逆的。超声估算膀胱重量的测量对监测BPH患者的治疗效果有价值。超声估算膀胱重量异常高达到80克或更多可能提示膀胱逼尿肌有退行性和不可逆的病理变化。

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