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我院1989年2月至1996年12月采用经尿道电切(TUR)治疗女性膀胱颈梗阻52例,疗效满意报告如下。 1 临床资料 1.1 一般资料:本组52例,年龄41～78岁,病程9个月～21年。所有病例均有程度不等的尿频、尿急、排尿费力及下腹部胀痛等症状,入院前已出现外溢性尿失禁5例、尿潴留12例;15例行尿道扩张治疗,效果欠佳。残余尿大于60mL 49例,术前留置尿管14例,膀胱造瘘4例。合并糖尿病5例、膀胱肿瘤3例,尿道肉阜2例。血肌酐尿素氮超过正常11例。全部患者均行膀胱尿道镜检查:经尿道扩张后21Fr镜鞘均可进入膀胱,41例膀胱颈后唇明显挛缩抬高,表面高低不平、充血水肿;11例膀胱颈环形增生,颈口缩窄变形,边缘呈锯齿状;其中15例输尿管间嵴肥厚隆起呈堤坝状改变。所有病例膀胱内假性憩室、小梁形成;测量尿道长度3.5～4.5cm。尿流动力学检查45例,最大尿流率(MFR)均小于20mL/s,15mL/s以下者42例。
Our hospital from February 1989 to December 1996 by transurethral resection (TUR) treatment of female bladder neck obstruction in 52 cases, the results reported as follows. 1 Clinical data 1.1 General information: The group of 52 patients, aged 41 to 78 years, duration of 9 months to 21 years. All cases had varying degrees of urinary frequency, urinary urgency, difficulty urinating and lower abdominal pain and other symptoms. There were 5 cases of spilled urinary incontinence and 12 cases of urinary retention prior to admission. Fifteen patients underwent urethral dilatation, which was ineffective. Residual urine was more than 60mL in 49 cases, preoperative catheterization in 14 cases, 4 cases of bladder fistula. 5 cases of diabetes mellitus, 3 cases of bladder cancer, 2 cases of urethral caruncle. Serum creatinine exceeded normal urea nitrogen in 11 cases. All patients underwent bladder urethra examination: urethral 21Fr sclerosis after sclerosis can enter the bladder, 41 cases of bladder neck posterior lip obvious contracture elevation, uneven surface, congestion and edema; 11 cases of bladder neck ring hyperplasia, neck narrowing Deformation, serrated edges; of which 15 cases of ureteral crest hypertrophy raised dike-like changes. All cases of bladder pseudo-diverticulum, trabecular formation; urethral length 3.5 ~ 4.5cm. Among the 45 patients with urodynamic examination, the maximum flow rate (MFR) was less than 20 mL / s and 42 patients under 15 mL / s.