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作者对6例BPH尿潴留的手术高危病人,采用最新设计的镀金前列腺螺旋管(Prostacath)治疗。置管全部成功,无手术死亡。术后所有病人均可自主排尿。1例有会阴部不适感,4例有尿急,应用抗胆硷药可减轻。平均尿流率6.1ml/s,术前尿细菌培养,5例阳性,术后3例无菌。平均置管8.6个月。3例取出螺旋管,其中,2例因病情好转行TURP,1例因螺旋管近端移位再发尿潴留。结果发现2例有结石痂形成,其中1例结石痂几乎充满了螺旋管尖端部分的整个腔隙,结石成分属磷酸钙石和鸟粪石。讨论:BPH急性尿潴留不能立即手术的病人,保留导尿管多有尿道不适感,且易产生尿路感尿。对等待手术者,采用前列腺螺旋管明显优于导尿管,操作简单而安全,置管后大多数尿潴留可解除。
The authors treated 6 patients with BPH urinary retention surgery at high risk using the newly designed Prostacath. All the successful management, no operative death. All patients after surgery can be independent urination. 1 case of perineal discomfort, 4 cases of urgency, anti-cholinergic drugs can be reduced. The mean urinary flow rate was 6.1ml / s. Preoperative urine bacterial culture was performed in 5 cases and 3 cases were sterile. The average catheter 8.6 months. 3 cases of spiral tube removed, of which 2 cases of TURP due to better condition, 1 case of proximal spiral coil recurrence of urinary retention. The results showed that there were 2 cases of callus formation, of which 1 case of stone scab is almost full of the entire tip of the helical cavity, the composition of stones are calcium phosphate and struvite. Discussion: BPH patients with acute urinary retention can not be surgery, urethral catheterization to retain more than the urethral discomfort, and easy to produce urinary tract flu. For patients waiting for surgery, the use of prostate spiral tube was significantly better than the catheter, the operation is simple and safe, after catheterization most of the urinary retention can be released.