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目的探讨经尿道前列腺电切术(TURP)后发生尿道狭窄的防治措施。方法收集资料完整的TURP术后尿道狭窄患者38例,术前术中检查均未发现尿道狭窄,术后因排尿困难、急性尿潴留就诊,经排泄性尿道造影、逆行尿道造影或尿道镜检查确诊为尿道狭窄。患者平均年龄69岁(56～88岁),良性前列腺增生病史平均5.8年(1～1 9年)。38例患者中,1 8例(47.4%)狭窄位于尿道外口,6例(1 5.8%)位于尿道海绵体部,1 1例(28.9%)位于球膜部,2例(5.26%)位于前列腺部,1例(2.63%)位于膀胱颈部。38例叶,23例行尿道扩张术治疗,9例行尿道内切开术治疗,6例行开放手术治疗。结果 38例患者平均随访时间15.4个月(12～48个月)。所有患者接受个体化治疗后均可维持正常排尿,其中2例须定期进行尿道扩张。结论尿道狭窄为TURP术后常见并发症,感染、术前留置导尿、术中损伤是最主要的危险因素,积极预防其发生、术后定期密切随访和早期治疗是治愈的关键。
Objective To investigate the prevention and treatment of urethral stricture after transurethral resection of the prostate (TURP). Methods Thirty-eight patients with urethral stricture were enrolled in this study. No urethral stenosis was found in the preoperative TURP postoperative examination. The patients were diagnosed with dysuria and acute urinary retention after operation, excretory urethrography, retrograde urethrography, or urethroscopy Urethral stricture. The average age of patients was 69 years (56 to 88 years), and the history of benign prostatic hyperplasia was 5.8 years (range, 1 to 19 years). Of the 38 patients, 18 (47.4%) had stenosis at the external urethral orifice, 6 (1.58%) were located in the urethra, 11 (28.9%) were located in the bulbus, and 2 (5.26% Prostate Department, 1 case (2.63%) located in the bladder neck. 38 cases of leaves, 23 cases of urethral dilation treatment, 9 cases of urethrotomy, 6 cases underwent open surgery. Results The average follow-up time of 38 patients was 15.4 months (range, 12-48 months). All patients were able to maintain normal urination after receiving individualized treatment, and 2 of them had regular urethral dilatation. Conclusions Urethral stenosis is a common complication and infection after TURP. Preoperative catheterization is the main risk factor for urethral stricture. Intraoperative injury is the most important risk factor. Prevention of the urethral stricture is the most important factor. Tight follow-up and early follow-up are the key to cure.