Analysis On Current Situation And Influencing Factors Of Urethral Stricture After Transurethral Electrovaporization Of Prostate

BackgroundAs china’s population is aging, Benign Prostatic Hyperplasia has become one of the most common diseases in middle-age and senior males. The main clinical manifestation is the Lower urinary tract symptoms which mainly shown as dysuria.Transurethra electrovaporization of prostate is recognized as the best surgical treament of Benign Prostate Hyperplasia.The most common postoperative complication is Urethral stricture, shown by the occurrence of postoperative dysuria,and patients develop frequent micturition,urgency of urination,incontinence of urine,Urine is endless which eventually leads to the occurrence of urinary retention.The occurrence of urethral stricture seriously affects the quality of patients’life.ObjectiveUsing the method of retrospective study to discuss the status quoin of US after TUVP and analysis high risk factors affecting US after TUVP,in order to provide effective scientific basis for effectively preventing and reducing the incidence of US after TUVP in future,clinical work and relieve the pains of patients and psychological,economic burden,thus enhance the satisfaction degree and the quality of life of patients.Methods1. Literature research Refer to TUVP and its postoperative complications through the CNKI,Wan Fang and Pubmed TUVP data base,especially related reports about US to analyse present influencing factors of US after TUVP at home and abroad.2.The expert interview Choose 10 department of urology experts to conduct semistructured interviews by convenience sampling method and eliminate catheter balloon model,water injection,traction mode through the meeting review of department of urology experts.On postoperative urethral strictures TUVP were discussed,the definition of the factors affecting the meaning of judge and determine methods of urethral stricture.Including the meaning of urethral stricture is defined as:history,physical examination,urethra spies examination,transurethral imaging examination and further surgical treatment,bladder urethra urethra expansion.3. Organize the questionnaire about influencing factors of US after TUVP Organi-ze the questionnaire about influencing factors of US after TUVP,which Contains:age,prostate size,amount of bleeding during the operation,preoperative indwelling catheter,preoperative urinary tract infection,number of Preoperative complications,the time of operation continuous,the time of Continuous traction,the time of postoperative bladder irrigation,the amount of bladder irrigation and the time of indwelling urethral catheterization.4. Questionnaire investigation By hospital uropoiesis surgical department assista-nce if find the hospital diagnosed as "BPH and after TUVP" and record patients’names, inquire their AD and record patients’contact way and the specific address.Questionnaire survey makes an investigation by the method of structured interview and using two ways: Home visits,telephone interview.Using home visits and telephone interview to Family visit or telephone interview the patients who were undergo surgery during March 2011 and March 2014 and met the Inclusion criteria,there by collect the clinical data of patients who suffer from US after TUVP.5. Statistical treatment Analysis the collected clinical data after reasonable assignment by the univariate analysis,related factor analysis and Logistic regression analysis,multiple factors using the statistical method to find the associated with a significant TUVP postoperative urethral stricture of influencing factors.Results1. The results of data collection The number of the patients collected who have met the inclusion criteria is 461, a total of 11 cases.The incidence of US after TUVP is 2.39%(11/461)2. The results by the univariate analysis of influenced factors about US after TUVP Test the age,prostate size,amount of bleeding during the operation,preoperative indwelling catheter,preoperative urinary tract infection, the time of operation continuous,the time of Continuous traction,the time of postoperative bladder irrigation,the amount of bladder irrigation and the time of indwelling urethral catheterization by the univariate analysis and the result shows that the age, the prostate size,the amount of bleeding during the operation,the number of Preoperative complications, the time of operation continuous, the time of Continuous traction,the time of indwelling urethral catheterization are compared,the difference has statistical significance,,P<0.05, the greater the age, resection of the prostate gland volume is larger, the longer the more intraoperative blood loss, operating time, the longer the duration of traction, the longer the time of indwelling urethral catheterization, the higher the incidence of postoperative stricture formation.However,when compare preoperative urinary retention,preoperative urinary tract infection, number of Preoperative complications,the time of bladder irrigation,there are no statistical significance,P>0.05.3. The results by the related factor analysis of influenced factors about US after TUVP For the univariate analysis statistically significant in the seven factors respectively with urethral stricture of correlation analysis,the related factors analysis result shows there is significant correlation between US and five factors,which are the prostate size, the time of operation continuous,the time of Continuous traction,the time of indwelling urethral catheterization,the difference has statistical significance,P< 0.05.However,when compare the age,the amount of bleeding during the operation,there are no statistical significance,P>0.05.4. The results by Logistic regression analysis of influenced factors about US after TUVP For the related factors analysis result shows there is significant correlation between US and five factors urethral stricture of the logistic regression analysis,the analysis result shows there are four factors,which are the prostate size,which arethe time of operation continuous,the time of Continuous traction,the time of indwelling urethral catheterization,the difference has statistical significance,P< 0.05.However,when compare the prostate size,there is no statistical significance,P>0.05.ConclusionsThe incidence of US after TUVP is 2.39%. The greater the age, resection of the prostate gland volume is larger, the longer the more intraoperative blood loss, operating time, the longer the duration of traction, the longer the time of indwelling urethral catheterization, the higher the incidence of postoperative stricture formation.They were from high to low,the time of Continuous traction,the time of indwelling urethral catheterization,the time of operation continuous.