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目的:探讨经尿道双极等离子前列腺电切(TUPKP)术后并发症及其防治措施。方法:随访统计419例TUPKP患者的术后近期并发症和远期并发症,分析其原因并总结防治措施。结果:419例TUPKP患者中,术后近期并发症有继发出血7例,暂时性尿失禁24例,排尿障碍26例,尿路刺激症状33例。远期并发症有附睾炎2例,前尿道狭窄20例,膀胱颈挛缩5例。术前有性生活者79例,术后放弃性生活者7例,勃起功能障碍(ED)1例;术后有性生活者71例,其中逆行射精56例。结论:等离子电切具备切剥准确、止血效果好的突出优点,对性功能影响不明显,但进口电切镜直径与我国患者尿道直径相比较粗,大力碎石钳经尿道操作处理膀胱结石均会引起尿道狭窄。提高对TUPKP术后并发症的认识对预防和处理并发症尤为重要。
Objective: To investigate the postoperative complications and prevention and treatment of transurethral bipolar plasma prostatectomy (TUPKP). Methods: The follow-up statistics of 419 cases of TUPKP patients with postoperative complications and long-term complications, analysis of the causes and prevention and treatment measures. Results: Among the 419 TUPKP patients, there were 7 cases of secondary bleeding, 24 cases of temporary urinary incontinence, 26 cases of urination disorder and 33 cases of urinary tract irritation. Long-term complications of epididymitis in 2 cases, 20 cases of anterior urethral stricture, bladder neck contracture in 5 cases. There were 79 cases of preoperative sexual life, 7 cases of sexual life after abortion, 1 case of erectile dysfunction (ED), and 71 cases of postoperative sexual life, including 56 cases of retrograde ejaculation. Conclusion: The plasma cutting has the advantages of accurate incision and good hemostatic effect, but has no obvious effect on sexual function. However, the diameter of imported resectoscope is thicker than that of urethra in our country. Will cause urethral stricture. Increasing awareness of TUPKP postoperative complications is particularly important in preventing and managing complications.