CAJ | 학술논문

目的：探讨经尿道膀胱颈内切开治疗女性膀胱出口梗阻的手术经验。方法女性膀胱颈纤维化致膀胱出口梗阻病例28例,患者年龄52~73岁,患者均有不同程度的下尿路症状。术前评估包括尿动力学检查和膀胱镜检：最大尿流率为4.2~15.2 mL/ s,平均尿流率(7.5±3.1)mL/ s。所有病例均行经尿道膀胱颈内切开(截石位5~7点部位)。术后从尿动力学和临床症状两方面进行评价。结果26例患者拔管后下尿路症状明显改善,2例因长期尿潴留膀胱顺应性差延迟1个月拔管,拔管后排尿明显改善。术后1个月尿流率检查：最大尿流率为13.6~24.8 mL/ s,平均尿流率(14.3±4.1)mL/ s(P <0.01),膀胱残余量为0~30 mL。未出现尿失禁及尿道阴道瘘,全部病例随访6个月~1年。结论经尿道膀胱颈内切开能有效地治疗因女性膀胱出口梗阻引起的下尿路症状。术前应当明确诊断,膀胱镜检及尿动力学评估是必要的。
목적：탐토경뇨도방광경내절개치료녀성방광출구경조적수술경험。방법녀성방광경섬유화치방광출구경조병례28례,환자년령52~73세,환자균유불동정도적하뇨로증상。술전평고포괄뇨동역학검사화방광경검：최대뇨류솔위4.2~15.2 mL/ s,평균뇨류솔(7.5±3.1)mL/ s。소유병례균행경뇨도방광경내절개(절석위5~7점부위)。술후종뇨동역학화림상증상량방면진행평개。결과26례환자발관후하뇨로증상명현개선,2례인장기뇨저류방광순응성차연지1개월발관,발관후배뇨명현개선。술후1개월뇨류솔검사：최대뇨류솔위13.6~24.8 mL/ s,평균뇨류솔(14.3±4.1)mL/ s(P <0.01),방광잔여량위0~30 mL。미출현뇨실금급뇨도음도루,전부병례수방6개월~1년。결론경뇨도방광경내절개능유효지치료인녀성방광출구경조인기적하뇨로증상。술전응당명학진단,방광경검급뇨동역학평고시필요적。
Objective To summarize experience with transurethral incision of the bladder neck(TUIBN) for the treatment of female bladder outlet obstruction ( FBOO). Methods Bladder outlet obstruction was diagnosed in 28 women 52 to 73 years of age, who presented with the lower urinary tract symptoms. Preoperative investigations included a urodynamic examination and cystoscopy. The maximal flow rate was from 4. 2 mL/ s to 15. 2 mL/ s[mean(7. 5±3. 1) mL/ s]. Transurethral incision of the bladder neck(TUIBN) was performed in all patients. Urodynamic result and clinical symptoms were assessed after operation. Results The lower urinary tract symptoms were resolved or improved in 26 patients. Urodynamic examination revealed an increased maximal flow rate and a decreased postvoid residual urine volume. The maximal flow rate was from 13. 6 mL/ s to 24. 8 mL/ s[mean(14. 3±4. 1) mL/ s] (P<0. 01) and postvoid residual urine(RU) volme was from 0 to 30 mL at one month postoperation. The follow-up period was from 6 months to 1 year. Conclusion Transurethral incision of the bladder neck(TUIBN) is effective in relieving the lower urinary tract symptoms owing to female bladder outlet obstruction(FBOO). Urodynamic evaluation is essential in making the correct diagnosis.