上海交通大学学报（医学版）

›› 2012, Vol. 32 ›› Issue (4): 408-.doi: 10.3969/j.issn.1674-8115.2012.04.008

• 专题报道（排尿功能障碍及盆底重建） • 上一篇    下一篇

女性原发性膀胱颈梗阻的TURBN手术治疗及病理结果分析

张晓鹏, 胡 浩, 张国喜, 王晓峰, 许克新   

  1. 北京大学人民医院泌尿外科, 北京 100034
  • 出版日期:2012-04-28 发布日期:2012-04-27
  • 通讯作者: 许克新, 电子信箱: cavinx@sina.com。
  • 作者简介:张晓鹏（1977—）, 副主任医师, 博士；电子信箱: zxpigm@sina.com。

Treatment of female primary bladder neck obstruction with transurethral resection of bladder neck and pathological analysis

ZHANG Xiao-peng, HU Hao, ZHANG Guo-xi, WANG Xiao-feng, XU Ke-xin   

  1. Department of Urology, Peking University People's Hospital, Beijing 100034, China
  • Online:2012-04-28 Published:2012-04-27

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摘要：

目的 探讨经尿道膀胱颈切开术（TURBN）治疗女性原发性膀胱颈梗阻（PBNO）的疗效及病理结果分析。方法 22例PBNO患者术前进行体检、尿常规、美国泌尿外科学会（AUA）评分、尿动力学检查、超声检查和膀胱尿道镜检查。采用BlaivasGroutz计算图诊断膀胱出口梗阻，以Olympus标准电切镜行TURBN手术，术后留置尿管24～72 h。结果 在22例患者中，4例为重度梗阻，10例为中度梗阻，8例为轻度梗阻。膀胱尿道镜检查可发现膀胱颈后唇抬高，膀胱壁小梁样增生。术后12个月复查，主观症状和客观指标均显著改善。术后病理检查提示腺性膀胱炎、纤维组织增生和慢性炎症。结论 对于药物治疗效果不佳的PBNO患者建议采用TURBN手术治疗。

关键词: 原发性膀胱颈梗阻, 经尿道膀胱颈切开术, 女性

Abstract:

Objective To investigate the outcomes of female primary bladder neck obstruction (PBNO) treated with transurethral resection of bladder neck (TURBN), and perform the pathological analysis. Methods Twenty-two women with PBNO were recruited, and preoperative examinations were conducted, including physical examination, urine routine, American Urological Association scoring, urodymamics, ultrasonography and cystoscopy. Bladder outlet obstruction was diagnosed according to Blaivas-Groutz nomogram, TURBN was performed with Olympus standard resectoscope, and urinary catheter was retained for 24 to 72 h after operation. Results There were 4 patients with severe obstruction, 10 patients with moderate obstruction and 8 patients with mild obstruction. Elevated posterior lip of bladder neck and trabecula hyperplasia of bladder wall were observed through cystoscopy. Twelve months after operation, all the symptoms and parameters were improved. Pathological examinations revealed glandular cystitis, fibrous tissue hyperplasia and chronic inflammation. Conclusion TURBN is an effective and safe method in treatment of PBNO, especially for patients with unsuccessful pharmacotherapy.

Key words: primary bladder neck obstruction, transurethral resection of bladder neck, female