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目的探讨手术治疗前列腺术后完全性尿失禁的效果。方法前列腺术后完全性尿失禁患者16例,包括耻骨上前列腺摘除术后2例,经尿道前列腺电切术后5例,经尿道前列腺气化术后8例,前列腺癌根治术后1例。年龄62～76岁,平均67岁。尿失禁病程10～22个月,经保守治疗无效。采用改良括约肌修补、球部尿道折叠加阴茎脚包埋术6例,球部尿道复合悬吊术10例。结果16例手术均顺利,无严重并发症。术后平均随访26个月,2组治愈、改善和无效者分别为3例和8例、1例和1例、2例和1例,成功率(治愈加改善)分别为66.7%和90.0%,总成功率为81.3%。结论改良括约肌修补、尿道球部折叠加阴茎脚包埋术和球部尿道复合悬吊术均为前列腺术后完全性尿失禁的有效治疗方法,但悬吊术的效果优于修补术。
Objective To investigate the effect of surgical treatment of complete urinary incontinence after prostatectomy. Methods Sixteen patients with complete urinary incontinence after prostatectomy included 2 cases after suprapubic prostatectomy, 5 cases after transurethral resection of the prostate, 8 cases after transurethral vaporization of the prostate, and 1 case after radical prostatectomy. Age 62 to 76 years, mean 67 years. Urinary incontinence duration of 10 to 22 months, after conservative treatment ineffective. Modified sphincter repair, ball urethral fold plus penile foot embedding in 6 cases, 10 cases of ball urethral composite suspension. Results 16 cases of operation were smooth, no serious complications. The patients were followed up for an average of 26 months. The cure, improvement and inefficacy of the two groups were 3 cases and 8 cases, 1 case and 1 case, 2 cases and 1 case, respectively. The success rates (cure and improvement) were 66.7% and 90.0% , The total success rate of 81.3%. CONCLUSIONS: Modified sphincter repair, urethral bulb folds and penile foot embedding, and ball urethral composite suspension are effective methods for the treatment of complete urinary incontinence after prostatectomy. However, the effect of suspension is better than that of repair.