An Analytical Study On The Cause Of Paruria After TURP

Backgroud and puurpose:Benign prostatic hyperplasia (BPH) is a common disease of old men, which is caused by many complicated factors. The intracavitary therapy of BPH can decrease the volume of prostate and enlarge the urethra. Because of little wound, little haemorrhagia in-operation and quick recovery post-operation, Transurethral resection of prostate (TURP) has taken place the open operation in a way, and is considered as the gold standard of surgical therapy of BPH. There are no significant differences between the complication of traditional open operation and that of TURP. Paruria is one of the common complications after TURP. From Nov 1996 to May 2005, there were 1280 patients who accepted TURP in our hospital, of which 102 patients suffered from Paruria after the operation.Materials and methods:From Nov 1996 to May 2005, The old male patients who were suffered from the lower urinary tract symptoms such as thamuria, nocturia and progressive dysuria were diagnosed as BPH by prostate specific antigen, digital rectal examination, international prostate symptom score (IPSS) quality of life score(QOLS) and urinary dynamics. The patients with inducation accepted TURP which were done by the surgeons qualified asassociate chief physician of our hospital. The pathological diagnosis after operation of all the patients was BPH.All the patients were accepted the TURP in the peridural anesthesia or combined spinal-epidural anesthesia. The order of resection of prostate was the median lobe, the bilateral lobe and the point part of prostate. The mean time of operation was 57minutes (15 to 90 minutes). The mean weight of the tissue cut was 32 grams (10 to 80 grams). The mean volume of haemorrhagia was 152 milliliters.Result:After 1 to 6 months, 102 patient suffered from thamuria, urgency, Urinary stream thinningz and progressive dysuria, of which 64 patients was diagnosed as urethrostenosis, 12 patients as remnant prostate, and 26 patients as disfunction of bladder. Then 62 patients accepted urethral sounding and urethral perfuse of cidomycin and decaesadril and the anti-infective therapy, and recovered after 2 to 6weeks. 2 patients accepted section of urethrostenosis and recovered. 12 patients accepted TURP once again and recovered. 26 patients accepted bladder training, drug . therapy, acupuncture and so on, and then the symptom relieve after 3 to 5 months.Conclusion:1. Urethrostenosis is the main reason of paruria after TURP.2. Obstruction of cystic outlet, powerless of detrusor muscle, instability of detrusor muscle and powerless of detrusor muscle combined obstruction are the reasons of paruria after TURP.3. Conservative operation can be considered in the patient who is diagnosed as powerless of detrusor muscle or instability of detrusor muscle.4. The examination of urinary dynamics is one of the method of choosing the patient who is suitable for TURP. It has some value for identifying the reason of paruria after TURP.