良性攝護腺增生切除或剜除術後併發反覆性復發膀胱頸狹窄的危險因子分析

陳致豪、林才揚、李高漢、劉建良、陳俊豪、蘇家震、謝昆霖、黃冠華

奇美醫學中心外科部泌尿科

Risk factors for highly recurrent bladder neck contracture after transurethral resection/enucleation of prostate for benign prostate hyperplasia

Zhi-Hao Chen¹, Chye-Yang Lim¹ Kau-Han Lee¹, Chien-Liang Liu¹, Chun-Hao Chen¹, Chia-Cheng Su¹, Jhih-Cheng Wang¹, Kun-Lin Hsieh¹, Steven K. Huang¹

Divisions of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan

Abstract

Purpose:

To determine the risk factors for highly recurrent bladder neck contracture(BNC) after transurethral resection/enucleation of prostate for benign prostate hyperplasia

Method:

We retrospectively collected the data of 277 patient with bladder neck contracture, which underwent  transurethral resection/enucleation of prostate for benign prostate hyperplasia. 204 patients(group 1) had de novo bladder neck contracture, which had no recurrence after following management with transurethral bladder neck incision(TUIBN). 73 patients(group 2) had refractory BNC after multiple TUIBN, which had recurrence times>=1 times. The information included prostate volume, bipolar or laser, resection or enucleation, PSA, Foley catheter durations and so on.  We performed univariate analysis and survival curves between the two groups.

Result:

The analysis revealed transurethral surgery type was a significant risk factor on the recurrent bladder neck contracture. The patients underwent ‘Enucleation with laser group’ had higher BNC recurrence rate compared to the patients in ‘Resection with bipolar group’, ‘Resection with laser group’, or ‘Vaporization group’. (P=0.048)

Conclusions:

The using of enucleation with laser as the transurethral surgery type is a statically significant risk factor for recurrent bladder neck contracture after transurethral resection/enucleation of prostate for benign prostate hyperplasia.