Comparison of laparoscopic bladder neck Y-V plasty versus transurethral resection of the bladder neck for bladder neck contracture

doi:10.3877/cma.j.issn.1674-3253.2024.04.015

Abstract

Abstract:

Objective

To investigate the effect of laparoscopic Y-V cystoplasty on bladder neck contracture (BNC) after benign prostatic hyperplasia (BPH) and compare it with transurethral resection of bladder neck (TURBN).

Methods

The data of 20 cases of BNC treated by laparoscopic cystocervical Y-V plasty from January 2019 to March 2022 in 990th Hospital of Joint Support Force were analyzed retrospectively, and compared with the data of 35 cases of BNC treated by TURBN. The observation group was laparoscopic bladder neck Y-V plasty, and the control group was TURBN group. In the observation group, the BNC first occurred in 16 cases after TURP and 4 cases after transurethral laser prostatectomy. In the control group, 28 cases BNC first appeared after TURP and 7 cases after transurethral laser prostatectomy. BNC in the observation group and the control group recurred after one or more times of transurethral resection of bladder neck or laser incision. The operation time, the decrease value of hemoglobin 24 hours after operation, the hospitalization time and the indwelling time of urinary catheter, residual urine volume (RUV), international prostate symptom scale (IPSS), maximum urinary flow rate (Q_max), and recurrence 6 months after surgery were compared.

Results

All patients successfully completed the operation. RUV and IPSS in the observation group and the control group decreased significantly (P<0.05) and Q_max increased significantly (P<0.05). The operation time, hospitalization time and indwelling catheter time of the observation group were significantly longer than those of the control group (P<0.05). The RUV and IPSS of the observation group after operation were significantly lower than those of the control group (P<0.05), and Q_max was significantly higher than those of the control group (P<0.05). There was no significant difference in the decrease of hemoglobin between the two groups (P>0.05). Follow up for 6 months showed that 1 case in the observation group recurred (5.00%) and recovered after twice urethral dilatation, while 10 cases in the control group recurred (28.57%). There was significant difference between the two groups (P<0.05).

Conclusion

Laparoscopic bladder neck Y-V plasty is superior to TURBN in improving RUV, IPSS and Q_max, and has lower recurrence rate. It is an effective method to treat recurrent BNC.

Key words: Laparoscopy, Y-V plasty, Bladder neck contracture, Transurethral resection of bladder neck, BPH

Dengke Yang, Mingzhi Cai, Xingxing Zhang, Qing Hu, Dayong Guo, Zhe Gao, Yongqi Bi, Wei Hu. Comparison of laparoscopic bladder neck Y-V plasty versus transurethral resection of the bladder neck for bladder neck contracture[J]. Chinese Journal of Endourology(Electronic Edition), 2024, 18(04): 392-396.

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References 17

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组别	例数	年龄(岁)	Q_max(ml/s)	IPSS(分)	RUV(ml)	BMI(kg/m²)
观察组	20	69±5	7.1±1.5	26.9±2.0	130±11	26.1±1.8
对照组	35	70±5	7.1±1.4	27.3±1.6	132±8	26.9±1.8
t值		0.818	0.165	0.847	0.675	1.682
P值		0.417	0.870	0.401	0.503	0.098

组别	例数	年龄(岁)	Q_max(ml/s)	IPSS(分)	RUV(ml)	BMI(kg/m²)
观察组	20	69±5	7.1±1.5	26.9±2.0	130±11	26.1±1.8
对照组	35	70±5	7.1±1.4	27.3±1.6	132±8	26.9±1.8
t值		0.818	0.165	0.847	0.675	1.682
P值		0.417	0.870	0.401	0.503	0.098

组别	例数	手术时间[min，(±s)]	血红蛋白下降值[g/L，(±s)]	住院时间[d，(±s)]	留置尿管时间[d，(±s)]	术后RUV[ml，(±s)]	术后IPSS[分，(±s)]	术后Q_max[ml/s，(±s)]	复发例数[例(%)]
观察组	20	75±10	1.8±0.7	8.7±1.0	14.2±0.5	20±3	6.2±1.1	20.4±1.6	1(5.00)
对照组	35	30±3	2.1±0.8	7.0±1.0	6.9±0.6	27±4	7.3±1.0	19.4±1.7	10(28.57)
统计值		t=24.157	t=1.418	t=5.912	t=46.426	t=6.930	t=3.740	t=2.084	χ²=4.420
P值		<0.001	0.162	<0.001	<0.001	<0.001	<0.001	0.042	0.036

组别	例数	手术时间[min，(±s)]	血红蛋白下降值[g/L，(±s)]	住院时间[d，(±s)]	留置尿管时间[d，(±s)]	术后RUV[ml，(±s)]	术后IPSS[分，(±s)]	术后Q_max[ml/s，(±s)]	复发例数[例(%)]
观察组	20	75±10	1.8±0.7	8.7±1.0	14.2±0.5	20±3	6.2±1.1	20.4±1.6	1(5.00)
对照组	35	30±3	2.1±0.8	7.0±1.0	6.9±0.6	27±4	7.3±1.0	19.4±1.7	10(28.57)
统计值		t=24.157	t=1.418	t=5.912	t=46.426	t=6.930	t=3.740	t=2.084	χ²=4.420
P值		<0.001	0.162	<0.001	<0.001	<0.001	<0.001	0.042	0.036

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