钬激光治疗前列腺电切术后膀胱颈口挛缩

摘要

目的：评价钬激光汽化切开术治疗继发性膀胱颈口挛缩的效果。方法：行经尿道前列腺电切手术的患者445例，随访时间后，术后膀胱颈口挛缩34例，29例静脉麻醉下完成膀胱颈口钬激光汽化电切，无保留导尿。结果：平均手术时间16 min 。与术前相比，患者术后国际前列腺症状评分（IPSS）、生活质量评分（Qol）、最大尿流率（Qmax）、残余尿量（PVR）得到明显改善（P＜0．05或0．01）。术中无出血，术后无尿潴留、尿失禁。结论：膀胱镜下钬激光汽化切开治疗膀胱颈口挛缩安全有效。%Objective : To evaluate the efficacy of clinical holmium :YAG laser vaporization dissection for the treatment of secondary bladder neck contracture (BNC) .Methods : Among the 445 patients undergoing transurethral resection of prostate (TURP) ,34 patients had developed BNC during the 18 months follow-up .And bladder neck dissection by Holmium :YAG laser vaporization were performed for 29 cases with intravenous anesthesia but without retention catheterization .Results : The mean operative time was 16 minutes .Compared with preoperation ,significant improvements regarding international prostate symptom score (IPSS) ,quality of life (Qol) ,maxium urinary flow rate (Qmax) ,postvoid residual volume (PVR) were observed after operation (P< 0 .05 or 0 .01) .There was no intraoperative bleeding and postoperative urinary retention and incontinence . Conclusions :Clinical holmium :YAG laser vaporization by cystoscopy is safe and efficacious for the treatment of secondary bladder neck contracture .