Multifactor Analysis Of Bladder Neck Contracture After Transurethral Plasma Kinetic Resection Of Prostate

Objective :To analyze the potential risk factors and the corresponding prevention methods for the development of bladder neck contracture(BNC)after transurethral plasma kinetic resection of prostate(TUPKRP).Methods :A retrospective review of 589 clinical data of patients undergoing TUPKRP from 2014.01 to 2016.12 investigated postoperative patients' possible related factors including: age,course of diseases,international prostate symptom score(IPSS),prostate-specific antigen(PSA),preoperative prostate volume,urinary infection,and basic diseases(diabetes,hypertension,coronary heart disease),urinary retention and prostatitis;electricity resection time and the weight of resection prostate per minute.operation;the time of catheter and catheter traction.Through follow-up and appointment,13 cases of patients turned into BNC after TUPKRP.Taking the patients in BNC with postoperative others for the control study,continuous variables in nonnormal distribution were tested by nonparametric test and the classification variables by chis-quare test.Multiple-factor Logistic regression analysis was used to test the variables(P<0.05)from the results of previous two tests.Results :The incidence of BNC after TUPKRP in 589 patients was2.20%,and the mean time of onset was 6.82 months later at average.The risk factors from the nonparametric test and chi-square test include preoperative prostate volume,electricity resection time and the weight of resection prostate per minute,urinary infection and prostatitis(P<0.05).Then the results of the five variables(P<0.05)was tested by multiple-factor unconditioned Logistic regression analysis reveal the risk factors including the preoperative prostate volume,urinary infection and prostatitis.(P<0.05,the difference was statistically significant),but electricity resection time and the weight of resection prostate per minute are ruled out from the risk factors(P>0.05).Conclusions :The following conclusions can be drawn from this study: there is no significant difference between the incidence of BNC and the average time of onset after TUPKRP with TURP.Preoperative prostate volume is less than 30 ml,and urinary tract infection and prostatitis are the influencing factors.During perioperative period,we should strictly control urinary tract infection and actively treat prostatitis.If the prostate is smaller than 30 ml,the conservative treatment should be used first.If the conservative treatment fails,we can simultaneously cut the fibrous ring at the 5 and 7 points of the bladder neck to the adipose tissue during operation,which can significantly reduce the incidence of BNC after operation.