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目的:分析良性前列腺增生(BPH)手术相关尿道狭窄发生的可能原因并总结其临床处理经验。方法:回顾性分析37例BPH手术相关的尿道狭窄患者的临床资料,平均年龄68.5岁。有开放手术史12例,经尿道手术史25例;狭窄位于前尿道6例,位于后尿道31例;35例采用钬激光切开或结合经尿道狭窄段疤痕切除术。最大尿流率评价疗效。结果:2例因阴茎部尿道全程狭窄采用尿流改道外,其余均进行了尿道狭窄治疗手术。4例尿道外口狭窄手术后留置导尿管5～7 d,拔出导尿管后排尿通畅,最大尿流率均大于15 ml/s。31例膜部以上尿道狭窄患者中,留置导尿管2～4周,随访1～21个月(平均11.5个月),23例患者排尿满意,最大尿流率平均14.3 ml/s;8例患者排尿欠佳,最大尿流率<8 ml/s。结论:钬激光切开或结合经尿道狭窄段疤痕切除术是治疗BPH手术相关尿道狭窄的有效手段,认真地对待BPH手术可减少尿道狭窄的发生。
Objective: To analyze the possible causes of urethral stenosis associated with benign prostatic hyperplasia (BPH) and to summarize its clinical experience. Methods: A retrospective analysis of 37 cases of BPH surgery associated with urethral stricture in patients with clinical data, mean age 68.5 years. There were 12 cases with open surgery history and 25 cases with transurethral surgery. Six cases were located in the anterior urethra in the stenosis and 31 in the posterior urethra. 35 cases were treated by holmium laser or combined with transurethral stricture scar resection. The maximum urinary flow rate evaluation of efficacy. Results: Two cases of urethral stricture were treated by urethral diversion due to the entire narrow urethra of the penis. 4 cases of urethral stenosis after catheter indwelling catheter 5 ~ 7 d, pull out the catheter urinary patency, the maximum flow rate of urine were greater than 15 ml / s. In 31 patients with urethral stricture, the urethral catheter was placed for 2-4 weeks, followed up for 1-21 months (average 11.5 months). Twenty-three patients were satisfied with urination and the maximal uroflow rate was 14.3 ml / s. Eight patients Patients with poor urination, the maximum flow rate <8 ml / s. Conclusions: Holmium laser incision or combined transurethral stricture scar resection is an effective method to treat BPH related urethral stricture. To treat BPH seriously can reduce the occurrence of urethral stricture.