Application of Suprapubic Needle Aspiration of Bladder in Transurethral Resection of the Prostate_West China Medical Journal

Authors：

ZHANG Li , HU Xingping , WANG Hao , XU Jun , DENG Lin , WANG Kai , LI Han

Department of Urology, the Fifth Chengdu People’s Hospital, Chengdu, Sichuan 611130, P. R. China;

Corresponding?author：

Keywords：

良性前列腺增生; 尿道狹窄; 穿刺引流; 經尿道前列腺電切術

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目的　探討前列腺體積＞60 mL的前列腺增生癥患者的手術安全性，提高部分合并尿道狹窄前列腺增生癥患者的手術實施率。方法　 2009年3月－2010年3月，行恥骨上膀胱穿刺引流下經尿道前列腺電切術（TURP）治療前列腺增生58例。年齡54～93歲，平均72歲，病程8個月～12年，平均7.2年；前列腺體積35～128 mL，平均78 mL；國際前列腺癥狀評分24～35分，平均30.2分；最大尿流率1.2～4.8 mL/s，平均1.8 mL/s；殘余尿量84～210 mL，平均160 mL。術前無尿潴留28例。結果　58例順利完成手術，其中2例伴包膜穿孔，9例前尿道狹窄者通過去外鞘電切鏡完成手術。所有患者切除前列腺組織體積18～86 mL，平均58 mL；術中沖洗液為5%葡萄糖液，用量18 600～42 500 mL，平均23 500 mL；手術時間45～185 min，平均70 min。術后病理檢查均示良性前列腺增生，術后住院時間3～8 d，平均5 d。術后患者最大尿流率為18～46 mL/s，平均32 mL/s。結論　恥骨上膀胱穿刺引流能降低膀胱內壓，減少水、糖分吸收，增加手術安全性，提高了部分合并前尿道狹窄的前列腺增生患者的手術幾率。

Citation： ZHANG Li,HU Xingping,WANG Hao,XU Jun,DENG Lin,WANG Kai,LI Han. Application of Suprapubic Needle Aspiration of Bladder in Transurethral Resection of the Prostate. West China Medical Journal, 2012, 27(6): 899-901. doi: Copy

1.	王延偉, 白正鈞, 孫永峰, 等. 經尿道前列腺電切術200例臨床應用體會[J]. 中國醫學創新, 2010, 7(33): 135-136.
2.	張楠木, 徐忠, 朱曉東. TURP術同時行恥骨上膀胱穿刺造瘺治療較大前列腺增生癥[J].遼寧醫學院學報, 2010, 31(2): 147-148.
3.	Ho CC, Eng HS, Das S. Results from an international multicentre double-blind randomized controlled trial on the perioperative efficacy and safety of bipolar vs monopolar transurethral resection of the prostate[J]. BJU Int, 2012, 109(7): E22.
4.	趙海茂, 王璟琦. 經尿道前列腺電切術并發癥分析及預防措施[J]. 基層醫學論壇, 2010, 14(19): 580-581.
5.	夏國建, 潘明開.膀胱穿刺造瘺在TURP中的應用[J]. 中外醫療, 2011, 30(12): 114.
6.	郭柳然, 郭亮, 胡現斌, 等. TURP術中采用恥骨上膀胱穿刺造瘺利弊分析[J]. 河北醫藥, 2011, 33(13): 1960-1961.
7.	那彥群, 葉章群, 孫光, 等.中國泌尿外科疾病診斷治療指南[M].北京: 人民衛生出版社, 2011: 122-123.
8.	Milicevic S, Grubor P, Lucic N. The evaluation of impact of BPH surgical treatment with the open prostatectomy and transurethral resection of the prostate methods on the quality of life[J]. Med Arh, 2011, 65(5): 274-277.
9.	馮艷紅, 姜華茂, 傅德望, 等.經尿道前列腺電切綜合征相關因素分析[J].山東醫學, 2011, 51(34): 89-90.
10.	李谷國, 董懷生, 李會勇.經尿道前列腺電切綜合征的防治[J].中外醫療, 2011, 30(21): 89.
11.	Baazeem A, Elhilali MM. Surgical management of benign prostatic hyperplasia: carrent evidence[J]. Nat Clin Pract Uro1, 2008, 5(10): 540-549．.
12.	Lee NG, Xue H, Lerner LB. Trends and attitudes in surgical management of benign prostatic hyperplasia[J]. Can J Urol, 2012, 19(2): 6170-6175.
13.	Kacker R, Williams SB.Endourologic procedures for benign prostatic hyperplasia: review of indications and outcomes[J]. Urol J, 2011, 8(3): 171-176.
14.	李彩虹, 劉海濤, 周香麗.經尿道前列腺電切術225例報道[J].中國醫藥指南, 2011, 9(36): 105-106.
15.	成澤民, 杜義堂, 曾東升, 等.經尿道前列腺電切術對高齡高危前列腺增生癥患者生活質量的影響[J].重慶醫學, 2010, 39(9): 1100-1101.
16.	Zhang X, Geng J, Zheng JH, et al. Photoselective vaporization versus transurethral resection of the prostate for benign prostatic hyperplasia: a meta-analysis[J]. J Endourol, 2012. doi: 10.1089/end.2012.0136.
17.	Goel A, Kumar A. Effect of the ratio of resected tissue in comparison with the prostate transitional zone volume on voiding function improvement after transurethral resection of prostate[J].Urology, 2012, 79(3): 747.
18.	Abidi SS, Feroz I, Aslam M, et al. Elective hemi transurethral resection of prostate: a safe and effective method of treating huge benign prostatic hyperplasia[J]. J Coll Physicians Surg Pak, 2012, 22(1): 35-40.
19.	Miller SW, Miller MS. Urological disorders in men: urinary incontinence and benign prostatic hyperplasia[J]. J Pharm Pract, 2011, 24(4): 374-385.

1. 　王延偉, 白正鈞, 孫永峰, 等. 經尿道前列腺電切術200例臨床應用體會[J]. 中國醫學創新, 2010, 7(33): 135-136.
2. 　張楠木, 徐忠, 朱曉東. TURP術同時行恥骨上膀胱穿刺造瘺治療較大前列腺增生癥[J].遼寧醫學院學報, 2010, 31(2): 147-148.
3. 　Ho CC, Eng HS, Das S. Results from an international multicentre double-blind randomized controlled trial on the perioperative efficacy and safety of bipolar vs monopolar transurethral resection of the prostate[J]. BJU Int, 2012, 109(7): E22.
4. 　趙海茂, 王璟琦. 經尿道前列腺電切術并發癥分析及預防措施[J]. 基層醫學論壇, 2010, 14(19): 580-581.
5. 　夏國建, 潘明開.膀胱穿刺造瘺在TURP中的應用[J]. 中外醫療, 2011, 30(12): 114.
6. 　郭柳然, 郭亮, 胡現斌, 等. TURP術中采用恥骨上膀胱穿刺造瘺利弊分析[J]. 河北醫藥, 2011, 33(13): 1960-1961.
7. 　那彥群, 葉章群, 孫光, 等.中國泌尿外科疾病診斷治療指南[M].北京: 人民衛生出版社, 2011: 122-123.
8. 　Milicevic S, Grubor P, Lucic N. The evaluation of impact of BPH surgical treatment with the open prostatectomy and transurethral resection of the prostate methods on the quality of life[J]. Med Arh, 2011, 65(5): 274-277.
9. 　馮艷紅, 姜華茂, 傅德望, 等.經尿道前列腺電切綜合征相關因素分析[J].山東醫學, 2011, 51(34): 89-90.
10. 　李谷國, 董懷生, 李會勇.經尿道前列腺電切綜合征的防治[J].中外醫療, 2011, 30(21): 89.
11. 　Baazeem A, Elhilali MM. Surgical management of benign prostatic hyperplasia: carrent evidence[J]. Nat Clin Pract Uro1, 2008, 5(10): 540-549．.
12. 　Lee NG, Xue H, Lerner LB. Trends and attitudes in surgical management of benign prostatic hyperplasia[J]. Can J Urol, 2012, 19(2): 6170-6175.
13. 　Kacker R, Williams SB.Endourologic procedures for benign prostatic hyperplasia: review of indications and outcomes[J]. Urol J, 2011, 8(3): 171-176.
14. 　李彩虹, 劉海濤, 周香麗.經尿道前列腺電切術225例報道[J].中國醫藥指南, 2011, 9(36): 105-106.
15. 　成澤民, 杜義堂, 曾東升, 等.經尿道前列腺電切術對高齡高危前列腺增生癥患者生活質量的影響[J].重慶醫學, 2010, 39(9): 1100-1101.
16. 　Zhang X, Geng J, Zheng JH, et al. Photoselective vaporization versus transurethral resection of the prostate for benign prostatic hyperplasia: a meta-analysis[J]. J Endourol, 2012. doi: 10.1089/end.2012.0136.
17. 　Goel A, Kumar A. Effect of the ratio of resected tissue in comparison with the prostate transitional zone volume on voiding function improvement after transurethral resection of prostate[J].Urology, 2012, 79(3): 747.
18. 　Abidi SS, Feroz I, Aslam M, et al. Elective hemi transurethral resection of prostate: a safe and effective method of treating huge benign prostatic hyperplasia[J]. J Coll Physicians Surg Pak, 2012, 22(1): 35-40.
19. 　Miller SW, Miller MS. Urological disorders in men: urinary incontinence and benign prostatic hyperplasia[J]. J Pharm Pract, 2011, 24(4): 374-385.

West China Medical Journal

Application of Suprapubic Needle Aspiration of Bladder in Transurethral Resection of the Prostate

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