最近の恥骨上式前立腺被膜下切除術に関する臨床統計的観察

Abstract

1974年1月より1981年6月までに岐阜大学泌尿器科において施行した恥骨上式前立腺被膜下切除術123例について, 統計的観察をおこなった.1)最年少48歳, 最年長89歳で平均年齢は70.1歳であった.2)平均術中出血量は590 mlであったか, 硬膜外麻酔が全身麻酔に比し有意に出血量が少なく, 麻酔方法が出血量の最大の因子であった.摘出重量と出血量にも相関を認めた.3)摘出重量は平均33.4 gで, 年齢が増加するにつれ重量も増加していたが, 術中に膀胱頸部硬化症の合併が重量20 g以下で27%と高率に認められた.術前残尿量と摘出重量とには相関を認めなかった.4)潜在性前立腺癌は4.1%に認められた.5)術後の副睾丸炎発症の予防としての精管切断術は意義が少ない.6)術後の尿路感染症は術前の細菌尿の有無とよく相関を示し, 術前の細菌尿に対するコントロールが重要である

Results of operation were analyzed statistically in 123 patients who underwent suprapubic prostatectomy for benign prostatic hypertrophy from 1974 through 1981. Age of the patients ranged from 48 to 89 years and the mean age was 70.1 years. The average amount of blood loss during operation was 590 ml. Amount of blood loss in patients operated under epidural anesthesia was less than that in the patients operated under general anesthesia. Furthermore, significant correlation was observed between amount of blood loss and the weights of enucleated prostate glands. The average weight of enucleated prostate glands was 33.4 g and the weight increased as the patient's age increased. Histological examination of the enucleated specimens revealed occult carcinoma in 4.1% of the patients. Association of bladder neck sclerosis was observed in 27% of the patients whose prostate weighed less than 20 g. Significance of prophylactic vasectomy for the prevention of postoperative epididymitis was considered to be low. Incidence of postoperative bacteriuria was higher in patients who had bacteriuria preoperatively than those without preoperative bacteriuria. Therefore, eradication of preoperative bacteriuria seemed important in the prevention of postoperative bacteriuria. No significant correlation was observed between postoperative residual urine volume and the weight of the enucleated prostate glands.