Analysis Of The Relative Factors Affecting Fistula Removal After TURP Combined With Cystostomy

Objective: To investigate the related condition of bladder fistula extraction after operation in patients of prostatic hyperplasia with weakening bladder detrusor,who were treated with TURP combined with cystostomy.Combined with the clinical data of patients before and after operation,The related factors affecting the removal of cystostomy were analyzed.Methods: We retrospectively analyzed the clinical data of 93 patients admitted from Shengjing Hospital affiliated to China Medical University from January 2012 to June2019 with prostatic hyperplasia and weakening bladder detrusor.All patients were treated with TURP combined with cystostomy.One week after operation,The catheter was removed.During the day,the patient was told to close the cystostomy tube,according to the normal urination habit,open the cystostomy tube after each discharge and record the postvoid residual(PVR),and open the cystostomy tube continuously at night.If the PVR recorded within one consecutive month is less than 50 ml,The bladder fistula tube will be removed.If the PVR is more than 50 ml,The cystostomy will be replace and continue to record the residual urine volume.Patients will be re-evaluated after 1 month.Assessment follow-up was conducted every 1 month for patients who met the criteria to remove the fistula;non-compliant patients continued to keep the fistula.Univariate analysis and logistic multivariate analysis were used to seek the relevant factors affecting the extraction of the fistula tube before and after operation.Results:A total of 93 patients were included in this study,with 59 successfully removed the fistula tube,accounting for 63.44%;and 34 without removing the fistula tube.Using univariate analysis and logistic multivariate regression analysis,it was found that there was a significant correlation between oral administration of ?-blocker,prostate volume,bladder pressure,course of disease and postoperative events of cystostomy(p <0.05).Conclusion:This study found that multiple factors should be taken into account in the successful removal of cystostomy,but the most important factor is the pressure ofdetrusor.The larger the prostate volume and bladder detrusor muscle,and the more oral ?-blocker drugs after operation,it is beneficial to remove the bladder fistula,and the longer the course of the disease affects the removal of the fistula to a certain extent.