摘要
目的探讨经尿道前列腺汽化电切术后继发囊性膀胱炎的诊治。方法 2012年1月~2016年12月8例良性前列腺增生行经尿道前列腺汽化电切治疗,术后6~24个月(平均13个月)再次出现尿频、尿急、排尿不畅及间隙性血尿发作,口服α或M受体阻滞剂临床症状改善不明显。膀胱镜检查诊断为部分前列腺残留合并继发囊性膀胱炎,再次行残留前列腺腺体汽化电切和囊泡切除术。结果手术时间8~31 min,平均16 min。术后留置导尿管3~5 d,平均3.3 d。术后病理:前列腺增生合并囊性膀胱炎。8例术后随访3~12个月,8例排尿畅,血尿消失,2例术后6个月仍有轻微尿频、尿急、夜尿增多,采用α受体阻滞剂口服治疗,无尿漏和尿失禁并发症。膀胱镜复查:膀胱颈部及前列腺尿道光整,无囊泡复发。结论经尿道前列腺汽化电切术后腺体残留可继发囊性膀胱炎,再次手术汽化电切残留腺体及囊泡,保持膀胱颈部及前列腺尿道光整,疗效满意。
Objective To explore the diagnosis and treatment of secondary cystic cystitis after transurethral vaporization resection of prostate( TVRP). Methods A total of 8 cases of benign prostate hyperplasia were treated by TVRP from January 2012 to December 2016. During 6-24 months( mean,13 months) after surgery,urinary frequency,urgency of urination,urination difficulty and hematuria happened again. Improvement of clinical symptoms was not obvious by oral α-or M-blockers. Cystoscopy showed residual prostate with secondary cystic cystitis. All the patients were given repeated resection of residual prostate and vesicle.Results The operation time was 8-31 min( mean,16 min). The postoperative indwelling catheter time was 3-5 d( mean,3. 3 d). Postoperative pathology specimens indicated prostate hyperplasia with cystic cystitis. During 6 months of follow-ups,all the patients had smooth urination without interstitial hematuria. Urinary frequency and urgency disappeared in 6 cases and were relieved in 2 cases( α-receptor blocker treatment). Cystoscopy re-examinations showed smooth bladder neck and prostatic urethra without vesicles. Conclusions Residual prostate after TVRP may lead to secondary cystic cystitis. Re-operation of vaporization of residual prostate and vesicles has good curative effects.
引文
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