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目的:分析经尿道等离子电切术治疗女性原发性膀胱颈梗阻的疗效及安全性。方法:女性48例,平均年龄62岁,病程平均3.5年。诊断依据症状、膀胱镜检查及尿动力学为主,辅以影像学和实验室检查。药物治疗无效,采用经尿道等离子电切治疗。结果:48例行经尿道等离子电切术,46例(95.8%)术后排尿症状明显改善。随访4～30个月,平均20个月。最大尿流率(Qmax)18.3～26.8ml/s,平均21.8ml/s。剩余尿量0～65ml,平均22ml。无尿瘘、尿失禁、尿道狭窄等严重并发症。结论:女性原发性膀胱颈梗阻多由膀胱颈纤维化或平滑肌增生引起,经尿道等离子电切对于α受体阻滞剂无效的患者,疗效确切、安全可靠。且能同期处理尿道息肉等伴发疾病。
Objective: To analyze the efficacy and safety of transurethral resection of plasma in patients with primary bladder neck obstruction. Methods: 48 females, mean age 62 years old, duration of an average of 3.5 years. Diagnosis based on symptoms, cystoscopy and urodynamics, supplemented by imaging and laboratory tests. Drug treatment is invalid, the use of transurethral plasma resection. Results: 48 cases underwent transurethral resection of the plasma and 46 cases (95.8%) had obvious improvement of urination symptoms. Follow-up 4 to 30 months, an average of 20 months. The maximum flow rate (Qmax) was 18.3 ~ 26.8ml / s with an average of 21.8ml / s. The remaining urine output 0 ~ 65ml, an average of 22ml. No urinary fistula, urinary incontinence, urethral stricture and other serious complications. Conclusion: Female primary bladder neck obstruction is mostly caused by bladder neck fibrosis or smooth muscle hyperplasia. The transurethral plasma resection is effective and safe for patients with invalid α-blocker. Concurrent treatment of urethral polyps and other concomitant diseases.