The effect of urethral catheter balloon dilation in the treatment of bulbar urethral stricture during transurethral bipolar plasma enucleation of the prostate
10.3760/cma.j.cn112330-20241008-00440
- VernacularTitle:经尿道前列腺双极等离子前列腺剜除术中应用尿管气囊扩张法治疗尿道球部狭窄的效果
- Author:
Daiyan WEN
1
;
Hongzhi YE
1
;
Shunhui YUAN
1
;
Hairong WEI
1
Author Information
1. 昆明医科大学第二附属医院泌尿外科，昆明 650101
- Publication Type:Journal Article
- Keywords:
Benign prostatic hyperplasia;
Urethral stricture;
Balloon dilation
- From:
Chinese Journal of Urology
2025;46(2):110-113
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of urethral catheter balloon dilation in the treatment of bulbar urethral stricture during transurethral bipolar plasma enucleation of the prostate (TUPEP).Methods:A retrospective analysis was conducted on the clinical data of 65 patients with benign prostatic hyperplasia (BPH) complicated by urethral stricture, who were admitted to the Second Affiliated Hospital of Kunming Medical University from January 2021 to January 2023. The patients were divided into two groups based on the intraoperative treatment of urethral stricture: the conventional group (32 cases) and the catheter group (33 cases). There were no significant differences between the conventional group and the catheter group in terms of age [(61.8±5.8) years vs. (63.0±5.0) years], body mass index [(25.0±2.5) kg/m 2 vs. (25.8±2.4) kg/m 2], international prostate symptom score [(22.6±3.3) vs. (23.0±3.7)], maximum urinary flow rate [(10.8±2.1) ml/s vs. (9.7±2.6) ml/s], residual urine volume [(108.8±20.6) ml vs. (100.6±18.9) ml], and prostate volume [(42.72±4.66) cm 3 vs. (42.99±5.83) cm 3] ( P>0.05). Both groups underwent TUPEP. In the conventional group, urethral dilators were used intraoperatively to gradually expand from F18/20 to F29. In the catheter group, an F22 urethral catheter balloon was used for hydrostatic dilation, with 0.5 ml of water injected each time, and repeated until successful(F27 sheath could pass through the stricture, and the scope could move freely with normal amplitude and clear vision) or until the total injected volume reached 4.0 ml. The following parameters were observed, icluding urethral orifice and endoscopic bleeding after dilation, operation time, postoperative catheter indwelling time, hospital stay, urinary tract infection (positive urine culture) during the postoperative period until discharge, and recurrence of urethral stricture within 6 months postoperatively (patients reported weak urinary stream, and F21 cystoscopy failed to pass through the stricture). Results:All surgeries were successfully completed, and intraoperative dilation was successful in all cases. The operation times for the conventional group and the catheter group were (144.9±30.1) minutes and (134.6±29.2) minutes, respectively, with no significant difference ( P>0.05). In the catheter group, the maximum injected volumes at successful dilation were 2.5 ml, 3.0 ml, 3.5 ml, and 4.0 ml in 5 cases(15.2%), 13 cases(39.4%), 10 cases(30.3%), and 5 cases(15.2%), respectively. In the conventional group, 5 cases(15.6%) had urethral mucosal tears, and 1 case (3.1%) developed a false passage. In the catheter group, only droplet bleeding was observed, with no mucosal tears or false passages. There were no significant differences between the conventional group and the catheter group in postoperative catheter indwelling time [(7.3±1.5) days vs. (6.8±1.5) days] or hospital stay [(5.9±1.5) days vs. (5.3±1.2) days] ( P>0.05). The catheter group had lower rates of postoperative urinary tract infection [(6 cases) 18.2% vs. (11 cases) 34.4%, P=0.037] and recurrence of urethral stricture within 6 months postoperatively [(1 case) 3.0% vs. (6 cases) 18.8%, P=0.041] compared to the conventional group. Conclusions:For mild bulbar urethral stricture discovered during TUPEP, urethral catheter balloon dilation is safe and feasible, with less bleeding at the dilation site and lower risks of postoperative urinary tract infection or urethral stricture recurrence.
