目的:经尿道前列腺电切术后膀胱颈挛缩是一种常见的并发症,但没有明确的诱发因素。在这项前瞻性研究中,我们评估了经尿道双极前列腺电切术后与膀胱颈挛缩相关的围手术期危险因素.
方法:该研究纳入了391例患者,这些患者在2020年10月至2023年10月期间由三名经验丰富的外科医生接受了经尿道双极前列腺电切术。43例患者有膀胱颈挛缩,并将其围手术期参数与随机选择的172例无膀胱颈挛缩患者进行比较。
结果:在一般和现在的历史特征方面,研究组之间没有显着差异。经尿道前列腺电切术后再次插管,术后复发性尿路感染,切除速度,膀胱颈收缩组尿道狭窄明显高于膀胱颈收缩组(P<0.05),而总PSA,前列腺总重量,排尿后残余尿量,切除的腺体重量,膀胱颈收缩组的切除时间和导管持续时间明显较低(P<0.05)。
结论:经尿道双极电切术后膀胱颈挛缩在小纤维化前列腺患者中更为常见,低总PSA,小后空残余尿量,术后复发性尿路感染发生率较高的患者和经尿道前列腺电切术后再次插管发生率较高的患者。
OBJECTIVE: Bladder neck contracture after transurethral resection of the prostate is a common complication but without clear predisposing factors. In this prospective study, we evaluated the perioperative risk factors associated with bladder neck contracture after bipolar transurethral resection of the prostate.
METHODS: The study included 391 patients who were admitted for bipolar transurethral resection of the prostate between October 2020 to October 2023 by three experienced surgeons. Forty three patients had bladder neck contracture and their perioperative parameters were compared with randomly chosen 172 patients without bladder neck contracture.
RESULTS: There were no significant differences between the studied groups regarding the general and present history characteristics. Re-catheterization after transurethral resection of the prostate, post-operative recurrent urinary tract
infection, resection speed, and associated urethral stricture were significantly higher among the bladder neck-contraction group (P < 0.05), while total PSA, total prostate weight, post void residual urine volume, resected gland weight, resection time and catheter duration were significantly lower among the bladder neck-contraction group (P < 0.05).
CONCLUSIONS: Bladder neck contracture after bipolar transurethral resection of the prostate is more common among patients with small fibrotic prostate, low total PSA, small post- void residual urine volume, those with a higher incidence of post-operative recurrent urinary-tract
infection and patients with a higher incidence of re-catheterization after transurethral resection of the prostate.