The T-plasty: a modified YV-plasty for highly recurrent bladder neck contracture after transurethral surgery for benign hyperplasia of the prostate: clinical outcome and patient satisfaction
The T-plasty: a modified YV-plasty for highly recurrent bladder neck contracture after transurethral surgery for benign hyperplasia of the prostate: clinical outcome and patient satisfaction
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DOI：
10.1007/s00345-016-1779-5
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发表时间：
2016-10-01
影响因子：
3.4
通讯作者：
Dahlem, R.
中科院分区：
文献类型：
--
作者：
Reiss, C. P.;Rosenbaum, C. M.;Dahlem, R.
描述一种改良的手术技术，用于治疗良性增生经尿道手术后高度复发的膀胱颈挛缩（BNC），并评估这种新技术的成功率和患者满意度。记录围手术期并发症，并根据Clavien分类进行分类。使用标准化问卷对患者报告的功能结局进行回顾性分析，评估狭窄复发、尿失禁、满意度和生活质量（QoL）变化。调查问卷包括经验证的IPSS和SF-8健康调查项目，手术时平均年龄为69.2岁（范围61-79），平均随访时间为26个月（范围3-46）。根据Clavien分类，未发生3级或更高级别的并发症。成功率为100%。无新发压力性尿失禁发生。80%的患者描述的尿流为非常强至中度，平均术后IPSS评分为11.3（范围4-29），平均术后IPSS-QoL为2.4（范围1-5）。90%的患者满意度非常高或很高，90%的患者生活质量改善。SF-8-健康调查显示与参考人群的值相当。T形成形术是治疗良性增生术后高度复发性BNC的一种安全和有价值的选择。与其他技术相比，它提供了多种优势，例如单阶段方法和通过使用两个血管化良好的皮瓣重建可靠的宽膀胱颈的机会。成功率、低并发症发生率和保留骨组织是非常令人鼓舞的。
To describe a modified surgical technique for treatment of highly recurrent bladder neck contracture (BNC) after transurethral surgery for benign hyperplasia and to evaluate success rate and patient satisfaction of this novel technique.Ten patients with highly recurrent BNC and multiple prior attempts of endoscopic treatment underwent the T-plasty. Perioperative complications were recorded and classified according to the Clavien classification. Patient reported functional outcomes were retrospectively analysed using a standardized questionnaire assessing recurrence of stenosis, incontinence, satisfaction and changes in quality of life (QoL). The questionnaires included validated IPSS and SF-8-health survey items.Mean age at the time of surgery was 69.2 years (range 61-79), and the mean follow-up was 26 months (range 3-46). No complications grade 3 or higher according to the Clavien classification occurred. Success rate was 100 %. No de novo stress incontinence occurred. Urinary stream was described as very strong to moderate by 80 % of the patients, mean post-operative IPSS-score was 11.3 (range 4-29), and mean post-operative IPSS-QoL was 2.4 (range 1-5). Patients satisfaction was very high or high in 90 %, and QoL improved in 90 %. The SF-8-health survey showed values comparable to the reference population.The T-plasty represents a safe and valuable option in treating highly recurrent BNC after surgery for benign hyperplasia. It offers multiple advantages compared to other techniques such as a single-staged approach and the opportunity for reconstruction of a reliable wide bladder neck by usage of two well-vascularized flaps. Success rate, low rate of complications and preservation of continence are highly encouraging.