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保留膀胱颈的经尿道前列腺电切与标准术式的疗效比较
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Abstract:
目的：比较保留膀胱颈的TURP与标准TURP的疗效。方法：研究选取2019年6月~2020年6月因前列腺增生于我院行经尿道前列腺电切术(transurethral resection of prostate, TURP)的患者137例，根据是否保留膀胱颈分为实验组(保留膀胱颈的TURP) 58例和对照组(标准TURP) 79例。比较两组的围手术期指标，术后6个月的国际前列腺症状评分(international prostatic symptom score, IPSS)、最大尿流率(maximum urinary flow rate, Qmax)和包括逆行射精在内的并发症发生率。结果：两组在手术时间、留置导尿管时间、血红蛋白下降、住院时间等方面差异无统计学意义。术后随访6个月两组IPSS评分与最大尿流率亦无明显差异。实验组逆行射精发生率明显低于对照组(32.8% vs 77.2%, P < 0.001)，但尿路梗阻、尿失禁、膀胱颈挛缩等并发症两组无明显差异。结论：与标准的TURP相比，保留膀胱颈的TURP在减少术后逆行射精率方面提供了更令人满意的临床结果。
Objective: To compare the efficacy of bladder neck preserving TURP with standard TURP. Methods: 137 patients receiving transurethral resection of prostate due to prostate hyperplasia in our hospital from June 2019 to June 2020 were selected. According to whether the bladder neck was preserved or not, the patients were divided into experimental group (TURP with preserved bladder neck) 58 cases and control group (standard TURP) 79 cases. Perioperative indicators, international prostatic symptom score (IPSS), maximum urine flow rate (Qmax), and incidence of complications including retrograde ejaculation were compared between the two groups. Results: There was no significant difference between the two groups in operation time, catheterization time, hemoglobin decrease and hospital stay. There was no significant difference in IPSS score and Qmax between the two groups after 6 months follow-up. The incidence of retrograde ejaculation in the experimental group was significantly lower than that in the control group (32.8% vs 77.2%, P < 0.001), but there were no significant differences in urinary tract obstruction, urinary incontinence, bladder neck contracture and other complications between the two groups. Conclusions: Compared with standard TURP, bladder neck sparing TURP provided a more satisfactory clinical outcome in reducing postoperative retrograde ejaculation rates.
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