两种不同术式+尿道扩张治疗TURP后尿道狭窄的疗效比较

摘要

Objective:To assess the efficacy and safety of two ways (Otis knife cutting and hard urethral probe dilation,S-shaped urethral probe and hard urethral probe dilation) to treat urethral stricture after TURP.Methods:Forty-one cases of urethral stricture after TURP were divided into two groups according to the will of patients:one group of 22 patients given transurethral Otis knife cutting and hard urethral dilation probe,and one group of 19 patients undergoing S-shaped urethral probe and hard urethral probe dilation.All patients were subjected to implantation of No.F20 Foley catheter for 1 month,and regular urethral dilation was performed for 3 months after urethral catheter removal.All patients were followed up for 6 months.The preoperative,operative and postoperative clinical parameters were compared between two groups,including quality of life score (QOL),maximum flow rate (Qmax),residual urine volume (RUV),operative time,blood loss,hospital stay,the curative rate,complications and postoperative incontinence.Results:After two groups of patients were followed up for 6 months,QOL,Qmax,and RUV were significantly improved,and no statistically significant difference was found between two groups (P>0.05).Blood loss,the curative rate,and urinary incontinence between tow groups showed no significant difference (P>0.05).The operation time and hospital time were signififcantly longer in the patients with the Otis knife incision group than in those with S-shaped urethral probe dilatation group (P<0.05).Conclusions:Both ways can be used to treat urethral stricture after TURP.S-shaped urethral probe and hard urethral probe dilation had shorter operative time and hospital stay,no risk of urinary incontinence,and can be easily accepted by patients.%目的:评价Otis刀尿道狭窄内切开+硬质尿道探子尿道扩张与S形丝状尿道探子+硬质尿道探子尿道扩张两种方法治疗TURP后尿道狭窄的疗效及安全性.方法:收治TURP后尿道狭窄患者41例,按患者治疗意愿分为两组,一组22例患者采取经尿道Otis刀尿道狭窄内切开+硬质尿道探子扩张术,另一组19例患者行S形丝状尿道探子+硬质尿道探子尿道扩张术.所有患者术后留置F20Foley尿管1个月,拔除尿管后行规律尿道扩张3个月,随访6个月后比较两组患者术前、术中、术后临床相关指标,包括生活质量评分(QOL)、最大尿流率(Qmax)、剩余尿(RUV)、手术时间、术中出血量、住院时间、治愈率及术后尿失禁并发症情况.结果:两组患者随访6个月后QOL、Qmax、RUV均明显改善,组间差异无统计学意义(P>0.05);术中出血量、治愈率、术后尿失禁组间比较差异无统计学意义(P>0.05);手术时间、住院时间Otis刀内切开组明显高于S形丝状尿道探子+硬质尿道探子扩张组,组间差异有统计学意义(P<0.05).结论:两种方法均可治疗TURP后尿道狭窄,S形丝状+硬质尿道探子扩张法手术时间及住院时间短、无尿失禁风险,易为患者接受.