Abstract：Objective: To analyze the incidence and risk factors of urethral stricture after transurethral prostate plasmatomy (PKRP). Methods: 541 patients with PKRP admitted to our hospital from January 2015 to March 2019 were selected as the research objects, followed up for 6 months to analyze the occurrence of postoperative urethral stricture. According to whether or not urethral stricture was complicated, they were divided into two groups: urethral stricture group and urethral normal group. Compared the perioperative information of the two groups, the factors with statistical significance were analyzed by logistic regression analysis. Pearson correlation was used to analyze the relationship between the independent risk factors and the maximum flow rate in patients with PKRP posterior urethral stricture. Results: Among 541 patients who received PKRP, 532 cases were followed up, with a follow-up rate of 98.34%; 31 cases of urethral stricture, with a incidence of 5.83%; by multiple factor Logistic regression analysis, preoperative urethral infection, intraoperative urethral dilatation and plastic surgery, continuous traction time, operation time and postoperative catheter retention time were independent risk factors of urethral stricture after PKRP (P<0.05); According to Pearson correlation analysis, the duration of traction, operation time and indwelling catheter time were negatively correlated with the maximum urinary flow rate (r-3.642, - 2.985, - 5.478, P 0.016, 0.025, 0.000, respectively); According to ROC curve analysis, the AUC of urethral stricture in PKRP patients with preoperative urethral infection or intraoperative urethral dilatation was 0.915, which was significantly higher than that of single index (P<0.05). Conclusion: The urethral stricture after PKRP is not uncommon. It is related to preoperative urethral infection, intraoperative urethral dilatation, continuous traction time, operation time and postoperative indwelling catheter time. The analysis of risk factors of urethral stricture after PKRP is helpful to predict the occurrence of urethral stricture, which is worthy of clinical attention.
[1] 王建龙,陈毅来,王蕾蕾,等.老年前列腺增生患者经尿道绿激光气化切除术后储尿期症状改善的多因素分析[J].中华老年医学杂志,2019,38(2):196~200. [2] Gul M, Altnta E, Kaynar M, et al.The predictive value of platelet to lymphocyte and neutrophil to lymphocyte ratio in determining urethral stricture after transurethral resection of prostate[J].2017,43(3):325. [3] 吴海啸,朱德胜,郭晓华,等.精准前列腺动脉栓塞术治疗高龄良性前列腺增生症的疗效观察[J].中华泌尿外科杂志,2017,38(7):549~550. [4] Sinanoglu O, Kurtulus FO, Akgun FS. Long-term effect of colchicine treatment in preventing urethral stricture recurrence after internal urethrotomy[J].Urology Journal, 2018, 15(4): 204~208. [5] 杨森,木海琦,王怡君,等.前列腺增生症术后尿路感染病原菌分布及细胞炎性机制研究[J].中华医院感染学杂志,2019,29(7):1072~1075. [6] 方强,沈洪亮.经尿道等离子前列腺分叶剜除术治疗体积>80mL前列腺增生患者的疗效分析[J].国际外科学杂志,2018,45(9):608. [7] Liu D, Fan L, Liu C, et al. Transurethral diode laser enucleation versus transurethral electrovaporization resection of the prostate for benign prostatic hyperplasia with different prostate volumes[J].Zhonghua nan ke xue = National journal of andrology, 2017, 23(3): 217~222. [8] Sachin D, Siddaiah CM, Senguttuvan KV, et al. Incidence of de novo erectile dysfunction after urethroplasty:a prospective observational study[J].World Journal of Mens Health, 2017, 35(2): 94~99. [9] Shillito S, Bourdoumis A. Endourological management of misplaced urethral catheter after radical prostatectomy[J].Annals of the Royal College of Surgeons of England, 2017, 100(4): 1. [10] 张建军,蔡维奇,方先林,等.经尿道前列腺电切术后前尿道狭窄相关因素分析[J].安徽医药,2017,21(10):1790~1792. [11] 施云峰,莫乃新,史红雷,等.经直肠前列腺穿刺后BPH患者行经尿道前列腺钬激光剜除术的疗效观察[J].中华男科学杂志,2019,25(5):403~407.
2020, Vol. 26 
冀公网安备13080202000677号