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本文作者总结了11例膀胱颈挛缩的手术治疗经验是可取的,效果很好。但是要注意膀胱颈后唇5～7点作V形切除时,组织切得够不够是个关键。切得太少,不解决问题;切得过多,不免造成膀胱颈直肠瘘或膀胱颈阴道瘘之虞。因此,手术中,术者可用右手食指伸向膀胱颈后唇切除后的后壁,左手食指伸入直肠或阴道前壁扪摸。若两个食指间感觉组织很厚,则说明后唇切得太少;若两个食指间感觉组织很薄,则说明后唇切除已够,不宜再切。其次,诊断上要注意,本病与良性前列腺肥大是病因不同的两种疾病,两种疾病伴发的机会不多。膀胱颈挛缩的发病年龄可从中年到老年,而良性前列腺肥大好发于55岁以上的老年人。因此,老年人患有膀胱颈挛缩者极易误诊为良性前列腺肥大,及至打开膀胱,发现前列腺不大,而不认识膀胱颈挛缩的大体病理表现,则又会感到不知如何处理。一般来说,膀胱颈挛缩者,其尿道内口(即膀胱颈部)呈现高度狭窄、充血、发红,甚至连小手指也通不过,这点值得注意。
The authors conclude that 11 cases of bladder neck contracture surgical treatment experience is desirable, the effect is good. However, pay attention to the posterior lip of the bladder neck 5 to 7:00 for V-shaped resection, the tissue cut enough is a key. Cut too little, do not solve the problem; cut too much, can cause bladder neck fistula or neck neck vaginal fistula risk. Therefore, during surgery, the surgeon can use his right index finger extended to the posterior wall of the posterior lip of the bladder neck, his left index finger extended into the rectum or vaginal anterior palpable touch. If the feeling between the two index finger tissue is very thick, then the back lip too small; if the feeling between the two index finger tissue is thin, then the lip resection is enough, should not be cut. Second, the diagnosis should pay attention to this disease and benign prostatic hypertrophy are two different causes of disease, two diseases associated with few opportunities. Bladder neck contracture age of onset from middle age to old age, and benign prostatic hypertrophy occurs in the elderly over the age of 55. Therefore, the elderly suffering from bladder neck contracture easily misdiagnosed as benign prostatic hypertrophy, and to open the bladder and found that the prostate is not large, but do not know the general pathological manifestations of bladder neck contracture, then I do not know how to deal with. In general, bladder neck contracture, the urethra mouth (ie bladder neck) showed a high degree of narrow, redness, redness, even the little finger also pass, it is worth noting.