经尿道前列腺腔内剜除术中保存前列腺前括约肌治疗低龄组前.PDFVIP

窑2708窑 南方医科大学学报(JSouthMedUniv) 2010;30(12) 经尿道前列腺腔内剜除术中保存前列腺前括约肌治疗低龄组前列腺增生 患者的疗效观察 徐亚文袁刘春晓袁郑少波袁李虎林袁方 平袁陈玢屾袁许 凯袁申海燕渊南方医科大学珠江医院泌尿外科袁广东 广州 510280) 摘要院 目的 探讨经尿道前列腺腔内剜除术治疗低龄前列腺增生患者的临床疗效遥 方法前列腺增生症患者 12例袁年 龄46~49 岁袁平均48.2 岁遥 采用腔内剜除法逆行切除增生的中叶及两侧叶袁保留前列腺前括约肌及前纤维肌肉区不受 损伤遥 随访观察下尿路症状改善及性生活相关情况遥 结果 12例随访3~6个月袁随访期间下尿路梗阻症状改善明显袁国 际前列腺症状评分渊I-PSS冤术前平均24依5.1袁术后3个月时降至8.8依1.4曰最大尿流率渊Qmax冤术前平均渊8.1依4.2冤ml/s袁术 后3个月时为渊20.1依4.2冤ml/s曰术前 12例均有膀胱残余尿渊12~244ml冤袁术后3个月仅4 例有残余尿渊30ml冤遥 所有患 者术后勃起功能正常袁术后 1个月 10例患者正常射精曰另2例分别在术后3个月及5个月恢复正常射精遥 结论 腔内 剜除术不仅可以改善患者的排尿梗阻症状袁也可以有效地避免损伤前列腺前括约肌袁提高患者术后性生活质量遥 关键词院剜除术曰经尿道切除术曰逆行射精曰良性前列腺增生 中图分类号院R697.32 文献标志码院A 文章编号院1673-4254(2010)12-2708-03 Transurethralenucleation of the prostate for treatment of benign prostatic hyperplasia in patientslessthan50yearsold XUYa-wen,LIUChun-xiao,ZHENGShao-bo,LIHu-ling,FANGPing,CHENBin-shen,XUKai,SHENHai-yan DepartmentofUrology,ZhujiangHospital,SouthernMedicalUniversity,Guangzhou510282,china Abstract: Objiective Toevaluatethetherapeuticeffectoftransurethralenucleationoftheprostatefortreatmentofbenign prostatichyperplasiainpatientsbelow50yearsofage. MethodsTwelvepatientswithbenignprostatichyperplasiapatients (meanage48.2years,range46-49years)underwenttransurethralenucleationoftheprostate.Themiddlelobeandtwolateral lobeswereenucleatedwiththepreprostaticsphincterandanteriorfibromuscularstromaprereservedduringtheoperation.The patientswerefolloweduptoevaluatethelowerurinarytractsymptomsandsexualactivityafterthesurgery. ResultsThe12 patientswerefollowedupfor3to6months. Thesymptomsoflowerurinarytractobstructionwereimprovedobviouslyafter thesurgery,andtheInternationalProstateSymptomScore(IPSS)decreasedfrom24依5.1to8.8依1.4andpeakurineflowrate (Qmax)increasedfrom8.1依4.2ml/sto20.1依4.2ml/sat3monthspostoperatively.Allthe12caseshadresidualurine(12-44 ml)preoperatively,butafterthesur