前列腺增生症疗效不佳者尿流动力学原因分析

为分析良性前列腺增生症（ＢＰＨ）疗效不佳的原因，对５８例曾接受经膀胱及Ｍａｄｉｇａｎ前列腺摘除术，经尿道前列腺切除术、经尿道激光治疗、微波及射频热疗等不同方法治疗并诉疗效不满意的ＢＰＨ患者进行尿流动力学测定，项目为充盈膀胱测压、压力－流率测定、ＥＭＧ测定、静态及加压尿道压力测定。测定结果出口梗阻（ＢＯＯ）占４８．３％、副尿肌收缩无力（ＤＤＣ）占１７．２％、逼尿肌不稳定（ＤＩＳ）占２０．７％、压力性

Analysis of urodynamic causes of poor treatment outcomes in benign prostatic hyperplasia patients

To analyse the causes of the poor treatment outcomes in benign prostatic hyperplasia (BPH) patients and discuss the clinical importance, the modern urodynamic studies were performed in 58 BPH patients who accepted for the prostatectomy through bladder (15 cases),Madigan's prostatectomy (6 cases ),Transurethral prostatectomy (TURP, 5 cases ), laser treatment (9 cases ), microwave thermotherapy (23 cases ), and complained with the unsatisfied treatment outcomes. The Dantec advanced urodynamic system was used to do the uroflowmetry,static and stress urethral pressure profilometry, filling cystometry-electromyography and voiding pressure-flow studies. All patients were performed the urodynamic tests. The urodynamic casues of the poor treatment outcornes were bladder outflow obstruction (BOO) occupied 48. 3%,detrusor instability (DIS) occupied 20. 7%, detrusor dyscontractility (DDC) occupied 17.2%, stress incontinence (SIC) occupied 5. 2% and neurogrnic bladder urethral dysfunction (NBUD) occupied 8. 6%' The incidences of the causes in the differential method were compared,and showed that the incidence of BOO in thermotherapy was the hightest (73.9 % ),BOO in two operations related to the complications,DDC and DIS were the secondary changes of BOO,obstinate DDC and DIS were differented from NBUD, NBUD from BPH combined with diabetes and cerebrovascular lesions was daiagnosed.These results showed that urodynamic tests were helpful to the diagnosis of BPH and BOO, the choice of treatment methods. the evaluation of treatment outcomes,the analysis of the causes of the poor outcomes and the futher treatment for the cases with the poor outcomes.