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目的:评价SKATER一步法膀胱造瘘管在经尿道前列腺电切术(TURP)中的作用及临床意义。方法:收集接受TURP治疗的38例高危、大体积BPH患者临床资料,其中同时行SKATER一步法膀胱造瘘术18例、不行膀胱造瘘术20例。比较两组手术时间、切除组织量、出血量、术后拔尿管时间、住院时间等指标。结果:两组患者的TURP与膀胱造瘘术均顺利完成。膀胱造瘘组一步法膀胱穿刺造瘘手术时间(3.0±0.5)min。两组术中出血量、切除腺体体积相近(P>0.05),均无患者发生水中毒或其他前列腺电切综合征。膀胱造瘘组TURP手术时间、术后拔除尿管时间以及住院时间均比非膀胱造瘘组明显缩短(P均<0.05)。术后随访3个月～2年患者恢复均较好,排尿均顺畅,无尿道狭窄,无尿失禁。结论:高危、大体积BPH患者在TURP术中应用一步法膀胱造瘘,效果良好,操作简便,术后恢复较快。
Objective: To evaluate the role and clinical significance of SKATER one-step cystostomy in transurethral resection of prostate (TURP). Methods: The clinical data of 38 patients with high-risk and large-volume BPH receiving TURP were collected. Among them, 18 cases were treated with SKATER one-step cystostomy and 20 cases without cystostomy. The operation time, resection volume, blood loss, postoperative catheter removal time and hospitalization time were compared between the two groups. Results: TURP and cystostomy were performed successfully in both groups. Bladder ostomy group one-step bladder puncture ostomy surgery time (3.0 ± 0.5) min. Two groups of intraoperative blood loss, resected glands volume (P> 0.05), no patients with water poisoning or other prostate resection syndrome. TURP operation time, postoperative catheter removal time and hospital stay in bladder fistula group were significantly shorter than non-cystostomy group (all P <0.05). Patients were followed up for 3 months to 2 years were better, urination were smooth, no urethral stricture, incontinence. Conclusions: High-risk, large-volume BPH patients with one-step cystostomy in the TURP surgery, the effect is good, easy to operate, postoperative recovery faster.