| 摘要 |
Objective: To investigate the therapeutic efficacy of transurethral incision of the bladder neck (TUI-BN) in men with primary bladder neck dysfunction (BND).
Material and Methods: Men diagnosed with BND refractory to alpha-adrenergic blockade underwent TUI-BN from 1999 to 2009 were enrolled in this study. Video-urodynamic studies (VUDS) were performed at baseline and repeated at 3 to 6 months for postoperative evaluations. The therapeutic results assessed by patient perception of bladder condition (PPBC) and data of maximum flow rate (Qmax), voided volume, post-voiding residual (PVR) amount, and detrusor pressure at Qmax (PdetQmax) were compared between baseline and after TUI-BN.
Results: A total of 46 patients completed the study. Compared with the baseline data, postoperative VUDS revealed that PdetQmax decreased in 28 patients, increased in 12, and persistent detrusor underactivity in 6. Overall, Qmax increased (baseline vs postoperatively, 5.72±4.77 vs 13.8±8.02 ml/s, p<0.001), voided volume increased (146±130 vs 185±109 ml, p=0.03) and PVR volume decreased (214±200 vs 108±136 ml, p<0.001) significantly after TUI-BN. PdetQmax increased significantly from 8.7±9.8 to 28.3±13.8 cmH2O (p=0.021) in the increased-Pdet group and PdetQmax decreased significantly from 65.2±47.1 to 40.1±32.6 cmH2O (p=0.012) in the decreased-Pdet group. PPBC improved by 2 scales in 36 (78%) patients including 22 (79%) in the decreased-Pdet and 10 (83%) in the increased-Pdet group. Four (67%) of 6 patients with detrusor underactivity could void with the aid of abdominal pressure after TUI-BN.
Conclusion: TUI-BN is effective for primary BND diagnosed by VUDS. Patients with either high or low PdetQmax and BND benefited from TUI-BN. |
