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目的探讨前列腺增生术后排尿困难的发生原因和治疗。方法分析总结49例前列腺增生术后排尿困难的原因和治疗方法。结果膀胱颈和后尿道狭窄32例,前尿道狭窄9例,多处尿道狭窄2例,腺体残留2例,复发1例,膀胱逼尿肌无力2例,神经源性膀胱1例。44例经尿道扩张及手术治愈,2例膀胱逼尿肌无力患者经药物及膀胱功能训练后排尿困难消失,术后随访3～18个月,平均6个月,均排尿通畅。3例患者长期留置耻骨上膀胱造瘘。结论尿道狭窄是前列腺增生术后发生排尿困难的主要原因,正确的术前诊断、术中及术后处理是预防发生排尿困难的关键。早期尿道扩张很重要。腔内手术是治疗尿道狭窄或腺体残留、前列腺增生复发的可靠方法。
Objective To investigate the causes and treatment of dysuria after benign prostatic hyperplasia. Methods The causes and treatment of dysuria in 49 cases of benign prostatic hyperplasia were analyzed and summarized. Results There were 32 cases of bladder neck and posterior urethral stricture, 9 cases of anterior urethral stricture, 2 cases of urethral stricture, 2 cases of residual gland, 1 case of recurrence, 2 cases of bladder detrusor weakness and 1 case of neurogenic bladder. 44 cases were cured by urethral dilation and operation. Two cases of bladder detrusor muscle weakness disappeared after drug and bladder function training. The patients were followed up for 3 to 18 months with an average of 6 months urination. Long-term indwelling suprapubic cystostomy in 3 patients. Conclusions Urethral stricture is the main cause of dysuria after prostatic hyperplasia. Correct preoperative diagnosis, intraoperative and postoperative management are the keys to prevent dysuria. Early urethral dilatation is very important. Endovascular surgery is the treatment of urethral stricture or residual glands, benign prostatic hyperplasia recurrence of a reliable method.