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目的:通过对经尿道镜于尿道外括约肌和前列腺内注射A型肉毒毒素(BTX-A)治疗难治性BPH病例的临床疗效的观察,寻求此类病例的最佳治疗方法。方法:具有手术指征但存在手术禁忌证且药物治疗无效的BPH病例35例,经尿道镜于尿道外括约肌、前列腺多点注射BTX-A进行治疗。对治疗前后患者症状及各项尿动力参数变化进行观察比较。结果:35例患者经尿道前列腺及尿道外括约肌注射A型肉毒毒素后5～13d治疗效果开始显现,平均7.2d。术后随访3～8个月,随访期未发生毒副作用。4例患者治疗后效果减退,准备行第2次注射。结论:BTX-A经尿道镜注射于前列腺治疗具有手术指征但存在手术禁忌证且药物治疗无效的BPH病例。操作简单,治疗效果确切,无毒副作用。
OBJECTIVE: To find the best treatment for such cases through the observation of the clinical efficacy of transurethral endoscopy in the treatment of refractory BPH with injection of botulinum toxin A (BTX-A) into the external urethral sphincter and prostate. Methods: Thirty-five BPH patients with surgery indications but contraindications to surgery and ineffective drug treatment were treated with transurethral ureteroscopy in extraurethral sphincter and multiple prostate injection of BTX-A. Before and after treatment of patients with symptoms and urodynamic parameters were observed and compared. Results: 35 cases of transurethral and extraurethral sphincter injection of botulinum toxin type A 5 ~ 13d after the start of treatment effect, with an average of 7.2d. All cases were followed up for 3 to 8 months. No side effects occurred during follow-up. 4 patients after treatment, the effect decreased, ready to line the second injection. Conclusions: BTX-A transurethral injection in the prostate for the treatment of BPH cases with surgical indications but contraindications to surgery and ineffective drug treatment. Simple operation, the exact effect of treatment, non-toxic side effects.