【摘要】 目的：探究经尿道钬激光前列腺剜除术（HoLEP）联合耻骨上膀胱造瘘治疗良性前列腺增生（BPH）合并亚临床尿道狭窄的疗效。方法：回顾性分析2018年1月至2021年1月潍坊医学院附属医院泌尿外科收治43例BPH合并亚临床尿道狭窄患者的临床资料，采用只经内鞘行HoLEP术，并联合耻骨上膀胱造瘘进行持续冲洗及组织破碎。比较手术前、后国际前列腺症状评分（IPSS）、生活质量（QOL）评分、最大尿流率（Qmax）、排尿后残余尿量（PVR）的变化，记录围手术期相关指标及并发症发生情况。结果：43例患者均手术成功，无膀胱黏膜损伤、尿道狭窄进展等并发症发生。术后6月相比术前IPSS[(5.74±1.46)vs.(21.83±3.32)分],QOL[(4.36±0.92)vs.(1.43±0.54)分], Qmax[(5.42±1.35)vs.(20.54±3.79)ml/s]及PVR[(17.58±5.55)vs.(117.13±20.52)ml]改善明显，差异均有统计学意义（P<0.01）。结论：HoLEP术联合耻骨上膀胱造瘘治疗BPH合并亚临床尿道狭窄的患者具有良好的疗效，且无尿道狭窄进展等并发症，有望在临床上进一步推广。更多还原

【Abstract】 Objective:To investigate the efficacy of transurethral holmium laser prostatice nucleation(HoLEP)combined with suprapubic cystostomy in the treatment of benign prostatic hyperplasia(BPH)complicated with subclinical urethral stricture. Methods:The clinical data of 43 patients with BPH complicated with subclinical urethral stricture admitted to Urology Department of Affiliated Hospital of Weifang Medical University from January 2018 to January 2021 were retrospectively analyzed. HoLEP was performed only through the inner sheath,combined with suprappubic cystostomy for continuous irrigation and tissue fragmentation. The changes of international prostate symptom score(IPSS),quality of life(QOL)score,the maximum flow rate(Qmax),post-voiding residual urine volume(PVR)were compared before and after operation,and perioperative related indicators and complications were recorded. Results:All the 43 patients were successfully operated without bladder mucosa injury and urethral stricture.At 6th month after surgery,IPSS[(5.74±1.46)vs.(21.83±3.32)points],QOL[(4.36±0.92)vs.(1.43±0.54)points],Qmax[(5.42±1.35)vs.(20.54±3.79)ml/s]and PVR[(17.58±5.55)vs.(117.13±20.52)ml]were significantly improved as compared with those before surgery(P < 0.01). Conclusion:HoLEP combined with suprapubic cystostomy has good efficacy in the treatment of BPH patients complicated with subclinical urethral stricture without complications such as progression of urethral stricture,which is expected to be further popularized in clinical practice.更多还原