目的提高对老年女性膀胱颈部梗阻的诊治水平。方法总结83例患者,平均年龄67岁,病程平均2年5个月。诊断方法为临床症状、尿流动力学、膀胱镜检查,影像学和实验室检查。膀胱镜检查显示膀胱颈后唇抬高、僵硬、狭窄伴膀胱内存在小梁小室者或膀胱颈部多发泡状水肿、绒毛状物者,行经尿道膀胱颈部电切术。结果该组83例均行经尿道膀胱颈部电切术,75例(90.4%)术后1周排尿症状明显改善,8例(9.6%)在手术后4～12周梗阻症状消失。切除的膀胱颈部病理报告为纤维平滑肌组织增生,均伴有慢性炎症。随访6～36个月,平均24个月,7例在术后2～4年膀胱颈部梗阻症状复发,再次经尿道膀胱颈部后唇切除治愈,最大尿流率和残余尿量明显改善。未发生尿失禁和尿瘘等并发症。结论经尿道电切术治疗老年女性膀胱颈部梗阻,手术操作简单,创伤小,出血少,疗效肯定。 Objective To improve the diagnosis and treatment of bladder neck obstruction in elderly women. Methods 83 cases of patients with an average age of 67 years, duration of an average of 2 years and 5 months. Diagnostic methods for clinical symptoms, urodynamics, cystoscopy, imaging and laboratory tests. Cystoscopy showed that the posterior lip of the bladder neck was elevated, stiff, and stenosed with multiple vesicular edema and villi in the bladder, or transurethral bladder neck resection. Results Totally 83 cases underwent transurethral resection of the bladder neck. 75 cases (90.4%) had obvious urination symptoms one week after operation, and 8 cases (9.6%) disappeared 4 to 12 weeks after operation. Bladder neck pathology report of fibrous smooth muscle tissue proliferation, are associated with chronic inflammation. The patients were followed up for 6 to 36 months with an average of 24 months. Seven patients had recurrence of bladder neck obstruction 2 to 4 years after operation. The transurethral resection of the urethral bladder neck and lip again cured the maximum urinary flow rate and residual urine volume significantly. No complications such as urinary incontinence and urinary fistula occurred. Conclusion Transurethral resection of bladder neck obstruction in elderly women, simple operation, less trauma, less bleeding, the effect is sure.