经尿道前列腺电切术后尿道狭窄原因分析及处理

摘要

Objective:To analyze the possible causes of urethral stricture after transurethral resection of the prostate ( TURP) and the preven-tion and treatment for it.Methods:The clinical data of 21 cases with urethral stricture after TURP were retrospectively analyzed.Patients were trea-ted with urethral dilatation, internal urethrotomy, residual prostate tissue excision or scar excision based on the severity of their urethral stricture. Results:The 21 cases were followed up for 3 to 6 months, the results of which were satisfactory.18 cases (86%) were treated with urethral dilata-tion, 16 cases of whom voided with a good stream;2 cases were still treated with urethral dilatation once a month and 1case was treated with ure-thral dilatation regularly.In the 3 cases who were operated on, 2 cases of them voided with a good stream and 1 case was treated with urethral dila-tation regularly.Conclusion:The common postoperative complication of TURP is urethral stricture , the main reasons for which are Iatrogenic.The treatment should be selected based on the location and degree of urethral stricture .Improving TURP skill and urinary catheter nursing is helpful in preventing the occurrence of urethral stricture.%目的：探讨经尿道前列腺电切术（ transurethral resection of the prostate，TURP）术后尿道狭窄的形成原因及防治措施。方法：回顾性分析21例TURP术后尿道狭窄患者的临床资料，针对不同情况分别采取尿道扩张、尿道内切开、残留前列腺组织切除或瘢痕切除等治疗措施。结果：随访3～8个月，行尿道扩张18例（86％）中，有16例排尿通畅，有2例仍进行巩固性尿道扩张，1次／月；3例（14％）手术患者中，有2例排尿满意，1例患者定期扩张尿道，总体效果满意。结论：尿道狭窄是 TURP 术后常见的并发症，其原因主要是医源性因素，需根据尿道狭窄的部位及程度选择适当的治疗方法。采取提高手术操作技能、加强尿管护理等措施有助于预防TURP术后尿道狭窄的发生。