标题：TURP术后腺体增生复发反复肉眼血尿者的再次手术方法探讨

      作者：倪 颖 1，丁雪飞 2，王启明 1，周金才 1，江汉群 1
    (1.南通大学附属建湖医院泌尿外科，江苏 盐城 224700；
2.苏北人民医院泌尿外科，江苏 扬州 225001)

      卷次： 2014年25卷8期

      【摘要】 目的 探讨反复肉眼血尿者经尿道前列腺电切术(TURP)后腺体增生复发的适宜手术方法。
方法 回顾性分析 2000年 8月至 2011年 8月间收治的 19例 TURP术后因腺体增生复发反复肉眼血尿接受
再手术患者的临床资料与随访结果。结果 与上次TURP时间间隔平均48.6个月。合并糖尿病9例(47.4%)；
口服抗栓药（阿司匹林等）8例(42.1%)；常规尿培养细菌阳性6例(31.6%)。18例(94.7%)获完全性随访，平均46.6
个月。9例行再次TURP，10例行开放性前列腺摘除术。术前国际前列腺症状评分(IPSS)、前列腺体积与术后
IPSS评分、最大尿流率(Qmax)、残余尿比较，两种术式的差异均无统计学意义(P>0.05)，但是末次随访时有7例患者
持续口服非那雄胺，仍会有经常性尿隐血，其中6例为再次TURP手术患者，占66.7%(6/9)。开放手术标本的共同
点是均为大小不等的结节样的腺体增生。结论 糖尿病、炎症感染、结石刺激、口服抗栓药等是TURP术后腺体
增生复发患者反复肉眼血尿的相关因素。对失去药物治疗耐心以及血尿严重的腺体增生复发患者应考虑再手
术治疗。从随访结果看开放性前列腺摘除术的效果优于再次TURP者。

      【关键词】 前列腺增生；复发；血尿；经尿道前列腺电切术

      【中图分类号】 R699 【文献标识码】 A 【文章编号】 1003—6350（2014）08—1184—03


Operation style for recurrence of prostatic hyperplasia patients with gross hematuria after the transurethral
resection of the prostate (TURP): open prostatectomy or TURP again.
NI Ying 1, DING Xue-fei 2, WANG Qi-ming 1,
ZHOU Jin-cai 1, JIANG Han-qun 1. 1.Department of Urology, Jianhu Hospital Affiliated to Nantong University, Yancheng
224700 , Jiangsu, CHINA; 2.Department of Urology, Subei People's Hospital, Yangzhou 225001, Jiangsu, CHINA

【Abstract】 Objective To investigate the surgical method of recurrence of prostatic hyperplasia patients with
gross hematuria after the transurethral resection of the prostate (TURP). Methods From 2000 to 2011, we retrospec-
tively analyzed 19 cases of postoperative TURP recurrence of prostatic hyperplasia due to repeated hematuria accepted
operation clinical materials and follow-up results. There was a mean of 48.6 months intervals for the last TURP. 9
(47.3%) patients with diabetes mellitus, 8 (42.1%) cases with taking oral antithrombotic drugs (aspirin), and 6 (31.6%)
cases with positive urine bacterial culture. Median follow-up was 46.6 months. Of the 18 (94.7%) patients were avail-
able for follow-up. Results 9 cases were performed repeat TURP, and 10 cases underwent open prostatectomy.
These conditions were not significantly different between TURP and open groups, including reoperative International
Prostate Symptom Score (IPSS), prostate volume and postoperative IPSS score, maximum urinary flow rate (Qmax), re-
sidual urine. However, 7 patients sustained regular urine oral non-finasteride at the end of the follow-up, and 6
(66.7%) cases of patients were underwent open prostatectomy. Common open operation specimens were ranged in size
from nodular hyperplasia. Conclusion Gross hematuria is one of the main causes for accepting reoperation after
TURP, and open operation provides improvement over TURP for reoperation.

      【Key words】 Prostatic hyperplasia; Recurrence; Hematuria; Transurethral resection of the prostate