Abstract：Objective： To compare the efficacy of transurethral resection of prostate (TURP) and bipolar plasma resection (PKRP) in the treatment of benign prostatic hyperplasia (BPH) and the associated risk factors for postoperative urethral stricture (US). Methods： The clinical data of 97 patients with BPH underwent TURP surgery and 140 patients underwent PKRP surgery were retrospectively analyzed. The curative effects of the two types surgery were compared to observe postoperative US occurrence in the patients, and the risk factors of postoperative US occurrence were analyzed by Logistic regression. Results： The operation time, urinary catheter indwelling time, hospitalization time and the incidence of postoperative urethral stricture in PKRP group were all lower than those in TURP group (P<0.05). After operative, there were 19 cases of postoperative US in 237 BPH patients, with the incidence of 8.02%. The course of disease, preoperative urinary tract infection, operation methods, operation time, postoperative urethral infection and urinary catheter indwelling time were related factors of postoperative US (P<0.05). Preoperative urinary tract infection, operation methods, postoperative urinary tract infection and long time of urinary catheter indwelling were risk factors for US after operation (P<0.05). Conclusion： The main risk factors for US after operation include urinary tract infection, operation method and prolonged indwelling time of the catheter. Clinically, we should pay close attention and try our best to avoid the occurrence of US.
[1] 翁鸿,曾宪涛,任选义,等.经尿道等离子双极电切术与钬激光剜除术治疗良性前列腺增生症的系统评价.中国循证医学杂志,2018,18(8):840-849. [2] PALANIAPPAN S, KUO TL, CHENG CW, et al.Early outcome of transurethral enucleation and resection of the prostate versus transurethral resection of the prostate. Singapore Med J, 2016,57(12):676-680. [3] 刘竹芳,黄文柱,刘敏,等.5α还原酶抑制剂联用α受体阻断剂对老年良性前列腺增生下尿路症状的效果及护理要点.中国药业,2017,26(12):38-40. [4] GRECHENKOV AS, GLYBOCHKO PV, ALYAEV YG, et al.Risk factors for anterior urethral strictures after transurethral resection of benign prostatic hyperplasia. Urologiia, 2015,48(1):62-65. [5] 毛宗林,钟海虎,汤志威,等.经尿道前列腺电切、双极等离子电切与2μm激光治疗前列腺增生术后并发尿道狭窄的相关因素分析.中华腔镜泌尿外科杂(电子版),2015,9(4):278-281. [6] 那彥群,叶章群,孙光.中国泌尿外科疾病诊断治疗指南.北京:人民卫生出版社,2011:163-211. [7] 邹鹤娟,李光辉.成人导管相关尿路感染的诊断、预防和治疗--2009年美国感染病学会国际临床实践指南.中国感染与化疗杂志,2010,10(5):321-324. [8] WELLIVER C, HELO S, MCVARY KT.Technique considerations and complication management in transurethral resection of the prostate and photoselective vaporization of the prostate. Transl Androl Urol, 2017,6(4):695-703. [9] 苏计,梁伟,丁全民,等.前列腺增生手术患者术后性生活质量及其影响因素研究.中国性科学,2017,26(11):16-18. [10] 宋文,王涛,凌青,等.铥激光前列腺汽化切除术与传统经尿道前列腺电切术疗效比较及术后尿道狭窄相关因素分析.中华男科学杂志,2017,23(12):1085-1088. [11] 王锐,丁晨,刘晓丽,等.经尿道前列腺等离子双极电切术对良性前列腺增生合并逼尿肌功能障碍患者的临床疗效研究.微创泌尿外科杂志,2016,5(6):364-366. [12] 程庆水,黄后宝,姜书传,等.经尿道前列腺电切术与等离子电切术对前列腺增生术后性功能影响的研究.中国男科学杂志,2015,29(8):37-39. [13] 程伟,刘修恒,陈明,等.经尿道双极等离子前列腺剜除术对良性前列腺增生尿道功能与性功能的影响.现代泌尿外科杂志,2015,20(12):859-862. [14] 张建军,蔡维奇,方先林,等.经尿道前列腺电切术后前尿道狭窄相关因素分析.安徽医药,2017,21(10):1790-1793. [15] TAN GH, SHAH SA, ALI NM, et al.Urethral strictures after bipolar transurethral resection of prostate may be linked to slow resection rate. Investig Clin Urol, 2017,58(3):186-191. [16] TAO H, JIANG YY, JUN Q, et al.Analysis of risk factors leading to postoperative urethral stricture and bladder neck contracture following transurethral resection of prostate. Int Braz J Urol, 2016,42(2):302-311. [17] 周宁,黄广林,李贵忠,等.口腔黏膜尿道成形术治疗经尿道前列腺电切术后前尿道狭窄疗效观察.中国临床医生杂志,2018,46(3):338-339. [18] 王鹏桥. 影响尿道前列腺电切术后尿道狭窄的因素分析.中国煤炭工业医学杂志,2015,18(8):1313-1315.
