Current Indication for Transurethral Resection of the Prostate and Associated Complications

經尿道前列腺切除手術是最常用來治療良性前列腺肥大的手術。本文中報告高雄醫學大學的經驗並探討其現今之適應症與患者患者結果之相關聯性。本研究包括111位於2000年5月2001年12月在高雄醫學大學接受經尿道前列腺切除手術的患者患者，並以回溯性分析患者之資料。依據手術之適應症，將患者患者分成三組：急性尿滯留、慢性併發症（包括腎功能受損、反性尿路感染或血尿、膀結石或息室、殘餘尿）和前列腺症狀。35位患者(31%)屬於急性尿滯留，28位患者(27%)為慢性併發症，48位患者(42%) 為前列腺症狀。不論是哪一組，大部分患者只有在藥物治療無效後才選擇經尿道前列腺切除手術。急性尿滯留組與慢性併發症組比前列腺症狀組有較大的前前腺體積(p=0.002)與較多的前列腺組織切除(p=0.05)。此外，急性尿滯留組的患者似乎有較高的危險於術後發生併發症，如尿路感染和再發性尿液滯留。我們建議對於急性尿滯留組的患者應於術前安排尿路動力學檢查以排可能同時合併膀收縮功能異常的情形，並同時給予合適的預防性抗生素以減少於術中或術後發生尿路感染的機會，尤其是在術前發現有菌尿的情形。

關鍵字

經尿道前列腺切除手術；良性前列腺肥大

並列摘要

Transurethral resection of the prostate (TURP) is the most common surgical procedure for relieving symptoms of benign prostatichyperplasia. Here, we report our experience of current indications for TURP and their associated outcomes at Kaohiung Medical University Hospital (KMUH). A total of 111 patients who underwent TURP at KMUH between May 2000 and December 2001 were included in this retrospective review. For each patient , the surgical indication was categorized into acute urinary retention, chronic complications (including renal impairment ,recurrent urinary infection ,bladder stone / diverticulum, postvoid residue, and recurrent hematuria), and symptomatic prostatism. Thirty-five patients (31%) had acute urinary retention , 28(27%) had chronic complications ,and 48(42%) had symptomatic prostatism. Most patients chose TURP only when medical treatment had failed to relieve symptoms, no matter what category they belonged to .Patients with acute urinary retention and chronic complications had larger prostates (p=0.002) and more tissue resected (p=0.05) than those with symptomatic prostatism. Patients with acute urinary retention seemed to be at greater risk of postoperative complications such as recurrent urinary retention and urinary tract infection. We suggest that urodynamic study may be necessary to rule out concomitant bladder dysfunction before surgery and that adequate prophylactic antibiotic treatment be used to decrease the risk of urinary tract infection during or after TURP ,especially when pyuria is noted preoperatively in patients with acute urinary retention.

並列關鍵字

transurethral resection prostate ； benign prostatic hyperplasia

國際替代計量

Current Indication for Transurethral Resection of the Prostate and Associated Complications

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