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目的 探讨耻骨上前列腺切除术常见并发症的防治方法。方法 紧贴前列腺尖部捻断尿道 ,摘除前列腺后 ,采用腺窝口 5、7点处“8”字缝合 ,后唇及三角区粘膜下U字型沟槽状切除 ,将后唇粘膜缝入腺窝内的外科包膜上 ;术后 3d应用硬膜外腔接微量止痛泵持续注入吗啡、布比卡因、氟哌啶混合液 1ml/h止痛。结果 采用以上方法经治 5 4例 ,除 3例硬膜外导管脱出 ,1例止痛泵接点漏液外 ,5 0例术后无疼痛及膀胱痉挛。拔除尿管后 3例出现一过性尿失禁 ;4 2例随访 3个月～ 2年 ,37例排尿通畅 ,5例排尿困难 ,其中腺体残留 2例 ,尿道口狭窄 2例 ,后尿道狭窄 1例。结论 采用耻骨上前列腺切除可有效防治术后并发症的发生。
Objective To investigate the prevention and treatment of common complications of suprapubic prostatectomy. Methods Twist urethra close to the tip of the prostate, the removal of the prostate, the use of gland socket 5,7 points at the “8” suture, the posterior lip and triangle submucosal U-shaped groove resection, the posterior lip mucosal suture Surgical capsule in the crypt; postoperative 3d epidural analgesia with a small amount of continuous injection of morphine, bupivacaine, haloperidol mixture 1ml / h analgesic. Results Fifty-four cases were treated by the above method. Except for 3 cases of epidural catheter prolapse and 1 case of pain pump leakage, 50 cases had no postoperative pain and bladder spasm. 3 cases had transient urinary incontinence after removal of the catheter, 42 cases were followed up for 3 months to 2 years, 37 cases had smooth urination and 5 cases had dysuria. There were 2 cases of residual glands, 2 cases of urethral stenosis, 2 cases of posterior urethral stricture 1 case. Conclusion The suprapubic prostatectomy can effectively prevent postoperative complications.