The T-plasty as therapy for recurrent bladder neck stenosis: success rate, functional outcome, and patient satisfaction
The T-plasty as therapy for recurrent bladder neck stenosis: success rate, functional outcome, and patient satisfaction
复制标题
DOI：
10.1007/s00345-017-2089-2
复制
发表时间：
2017-12-01
影响因子：
3.4
通讯作者：
Reiss, C. Philip
中科院分区：
文献类型：
--
作者：
Rosenbaum, Clemens M.;Dahlem, Roland;Reiss, C. Philip
Purpose To determine success rate（SR），functional outcome，and patient satisfaction of a modified YV-plasty for reconstruction of the bladder neck in case of recurrent bladder neck stenosis（BNS）after transurthal surgery of the prostate：the T-plasty.Patients and methods我们确定了2008年12月至2016年7月期间在我们中心接受T-plasty的所有患者。审查患者病历。在随访（FU）时通过电话和邮件询问患者。主要终点为SR。次要终点为并发症、复发、满意度和生活质量的变化。手术时的中位年龄为69岁（IQR 62-73）。大多数患者因TUR-P发生BNS [n = 25（83.3%）]。围手术期无严重失血和严重并发症发生。中位随访时间为45（IQR 18-64）个月。3例患者失访。成功率为100%。与术前Q（max）相比，术后平均Q（max）显著改善[术前6.79（SD +/- 4.76）ml/s vs术后24.42（SD +/- 12.61）ml/s;（t（5）= 4.12，p = 0.009）]。平均排尿后残余尿显著减少[术前140.77（SD +/- 105.41）ml vs术后14.5（SD +/- 22.42）ml;（t（9）=-3.86，p = 0.004）]。1例患者术后发生新发尿失禁。平均ICIQ-SF评分为1.2（SD +/- 2.27）。88.5%的患者对手术感到满意或高兴。75%的患者声称他们的生活质量得到了（强烈）改善。结论T形成形术是治疗复发性BNS的一种有价值的选择。SR、复发率和高患者满意度非常令人鼓舞。
Purpose To determine success rate (SR), functional outcome, and patient satisfaction of a modified YV-plasty for reconstruction of the bladder neck in case of recurrent bladder neck stenosis (BNS) after transurethral surgery of the prostate: the T-plasty.Patients and methods We identified all patients who underwent T-plasty at our center between December 2008 and July 2016. Patients' charts were reviewed. Patients were queried by telephone and by mail at time of follow-up (FU). Primary endpoint was SR. Secondary endpoints were complications, continence, satisfaction, and changes in quality of life measured by validated questionnaires.Results Thirty patients underwent the T-plasty. Median age at surgery was 69 (IQR 62-73) years. Most patients had BNS due to TUR-P [n = 25 (83.3%)]. No severe blood loss or severe complications occurred perioperatively. Median FU was 45 (IQR 18-64) months. Three patients were lost to FU. Success rate was 100%. Compared to pre-OP Q(max), mean Q(max) post-OP improved significantly [pre-OP 6.79 (SD +/- 4.76) ml/s vs post-OP was 24.42 (SD +/- 12.61) ml/s; (t(5) = 4.12, p = 0.009)]. Mean post-void residual urine decreased significantly [pre-OP 140.77 (SD +/- 105.41) ml vs post-OP 14.5 (SD +/- 22.42) ml; (t(9) = -3.86, p = 0.004)]. One patient developed a de-novo-incontinence post-OP. Mean ICIQ-SF Score was 1.2 (SD +/- 2.27). 88.5% of patients were pleased or delighted by surgery. 75% of patients claimed their quality of life has been (strongly) improved.Conclusions The T-plasty is a valuable option as treatment of recurrent BNS. SR, rates of continence, and high patient satisfaction are very encouraging.