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岭南现代临床外科 ›› 2017, Vol. 17 ›› Issue (06): 640-644.DOI: 10.3969/j.issn.1009-976X.2017.06.003

• 论述 • 上一篇    下一篇

前列腺电切术后尿道狭窄原因分析及治疗

黄晨 1,2 徐煜宇 1,2 梁健 1,2 盛明 1,2 徐桂彬 1,2 李逊 1,2*   

  1. 1. 广州医科大学附属第五医院 2.广州医科大学微创新技术与产品转化中心
  • 通讯作者: 李逊

Causes and therapy of urethral stricture after transurethral resection of prostate

HUANG Chen1,2, XU Yuyu1,2,LIANG Jiang1,2,SHENG Ming1,2,XU Guibin1,2,LI Xun1,2.   

  1. 1 Department of Urology,the Fifth Affiliated Hospital of Guangzhou Medical University,Guangzhou 510700,China; 2 Center for the Innovation and Translation of Minimally Invasive New Techniques,Guangzhou Medical University,Guangzhou 510700,China.
  • Online:2017-12-20 Published:2017-12-20
  • Contact: LI Xun

摘要:

经尿道前列腺电切术是治疗良性前列腺增生的首选手术方法,但前列腺电切术后尿道狭窄发生率较高,给老年患者带来了巨大痛苦。本文将就经尿道前列腺电切术后尿道狭窄发生原因、预防及治疗措施进行综述。经尿道前列腺电切术后尿道狭窄发生的主要原因有膀胱镜鞘过粗、手术操作暴力、手术切除速率慢、电流返流灼伤、尿路感染等。目前最佳治疗方式仍有许多争议,手术治疗方式主要包括尿道扩张术(金属探条尿道扩张术、高压球囊尿道扩张术等)、腔内尿道狭窄内切开术(钬激光、冷刀尿道狭窄内切开等)、尿道成形术(口腔黏膜、膀胱黏膜、阴茎皮瓣、组织工程移植物)等。

关键词: 前列腺电切术, 治疗, 尿道狭窄, 原因分析

Abstract:

Transurethral resection of the prostate is the preferred surgical procedure for the treatment of benign prostatic hyperplasia,but the complications such as urethral stricturebrings great pain to the elderly patients after transurethral resection of the prostate. This article will reviewthe causes of stricture of urinary tract due to transurethral resection,the measures of prevention and treatment. The main causes of urethral stricture are associated with cystoscope sheath ,operation violence,slowing operation,current reflux burn,urinary tract infection. Although there are still many controversies on the best way of treatment at present,the current surgical procedures include urethral dilatation(metal probe urethral dilatation,high pressure balloon urethral dilatation,etc.),endovascular stenosis incision(holmium laser ,cold knife urethral stricture ,etc.),urethroplasty(oral mucosa ,bladder mucosa ,penile flap ,tissue engineering graft).

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