Benign prostatic hyperpasia kev kuaj mob, kho mob thiab qhia kev noj qab haus huv ⅱ

4. Kev Kho Mob Kho

BPH yog tus kab mob uas muaj tus kab mob. Qee tus neeg mob thaum kawg yuav tsum tau kho kev phais pov thiab nws cuam tshuam rau kev ua kom zoo ntawm lub neej thiab qhov teeb meem tshwm sim. BPH cov neeg mob uas muaj mob hnyav rau hauv lub tsev loj uas muaj cuam tshuam lawvLub neej zoo, tshwj xeeb yog cov uas muajKev kho tshuaj tsis zoo lossis tsis kam lees txais kev kho tshuaj, tuaj yeem xaiv kho kev phais mob.
Thaum Bph Ua rau cov kev mob uas ua hauv qab no, kev phais mob tau pom zoo:

Tshuaj ntsuab tshiab rau kev noj qab haus huv prostate

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Ntxhw tso zis tso zis (tsis muaj peev xwm rau tso zis tom qab tsawg kawg 1 tus catheter tshem tawm lossis 2 ugine returys);
HmongRurren Hematuria;
Ntxhw tso zis tso zis;
④bladder pob zeb; ⑤secondently sab sauv tso zis rau hauv hydrops (nrog lossis tsis muaj kev puas tsuaj ntawm lub raum).
Thaum BPH cov neeg mob muaj Inguinal Helnia, cov neeg hemorrhoids lossis lub chaw kuaj mob qis dua yog tias nws pom zoo ua kom muaj kev pom zoo. Kev xaiv ntawm txoj kev kho yuav tsum txiav txim siab tus kws kho mob kev paub, tus neeg mob lub tswv yim, qhov ntim ntawm tus neeg mob tus kab mob sib xws thiab tus neeg mob cov lus pom zoo thiab tus neeg mob sib thooj.
Kev phais mob BPH muaj xws li kev kho mob classic / hloov kho kev phais mob, kev kho laser thiab lwm txoj kev kho. Cov kev kho mob ntawm BPP yog qhov cuam tshuam ntawm cov neeg mob uas cov neeg mob uas cov neeg mob (xws li IPSs) thiab cov hom phiaj siab tshaj plaws (xws li tso zis ntau tshaj plaws). Txoj kev ntsuam xyuas ntawm txoj kev kho mob yuav tsum xav txog ntau yam kev kho mob xws li kev kho mob, teeb meem kev teeb meem kev teeb meem, kev mob teeb meem thiab kev ua haujlwm thiab kev ua si thiab kev ua haujlwm.

4.1 Kev phais mob classic

Feem ntau suav nrog kev hloov pauv ntawm prostate (turp), hloov chaw ntawm prostate (tup) thiab qhib prostatecy.

4.1. 1. Turp Turp feem ntau yog tsim nyog rau kev kho mob BPH ntawm BPH cov neeg mob nrog kua roj prostate tsawg dua 80 ml. Cov kws tshaj lij kws tshaj lij tuaj yeem muab cov kev txwv tsis pub muaj cov kua paug [53].
4. 1. 2 Tuip Tuip yog txiav 1 txog 2 cov ntsiab lus ntawm cov nqaij mos uas nyob ib ncig ntawm qhov zis. Cov txheej txheem no feem ntau haum rau cov neeg mob nrog cov tshuaj prostate tsawg dua 30 ml thiab tsis muaj nruab nrab lobe hyperplasia. Nws tsis tshua siv hauv Suav [{54-55].

Cov tshuaj ntsuab contance cov txiaj ntsig tshiab rau kev mob prostate

4.1.3 qhib prostatecy

Kev tshawb fawb ntxov tshaj plaws tau qhib prostatecy, feem ntau dhau los ntawm suprappleceeb lossis retropubic txoj hauv kev kom tshem tawm cov ntaub so ntswg kub proppastate. Nws yog feem ntau haum rau cov neeg mob nrog cov kua paug postate

4.2 Kev Hloov Cov Nqi Laim Laser Laser Laser / Vaporization / Kev Tsim Tawm ntawm Prostate

Laser muaj kev cuam tshuam zoo thiab hemostasis cov teebmeem, tsis yog-conductive thaj chaw thiab cov txiaj ntsig hauv thermal puas [58]. Yog li ntawd, nyob rau hauv xyoo tsis ntev los no, hloov kev phais laser laser laser tau dhau los ua kev kho mob tseem ceeb rau BPH. Prostate Laser phais yog kom ua tiav lub hom phiaj ntawm kev tshem tawm cov ntaub so ntswg, txiav thiab tshem tawm cov ntaub so ntswg, xws li kev hloov pauv laser txiav) los ntawm laser. Cov ntsiab lus thiab wavelengths ntawm ntau yam lasers uas siv hauv kev hloov chaw Laser prostatecy sib txawv, yog li lawv muaj lawv tus kheej phais cov kev tshwm sim.

4.2.1 Holmium laser

Holmium laser yog qhov tseem ceeb tshaj plaws kawm lasas thiab tuaj yeem siv los tshem tawm prostate hyperplasia ntawm ntau qhov ntau [59]. Tam sim no Holmium laser ua rau lub prostate (holep) tau pom tias muaj peev xwm ntawm BRH cov txheej txheem thiab muaj txiaj ntsig zoo dua li turp. Txawm li cas los xij, nws yuav tsum tau tus kws phais kom muaj kev txawj ntse txaus thiab muaj kev kawm nkhaus ntev. Tsis tas li ntawd, zais zis kev puas tsuaj yuav tshwm sim thaum crushing thiab tshem cov ntaub so ntswg [2, 60]. Tus kws phais neeg cov kev ua tiav yog qhov tseem ceeb tshaj plaws hauv kev txo qhov tshwm sim ntawm cov teeb meem tom qab Holep.

4.2. 2 Green Laser

Lub wavelength ntawm ntsuab laser yog 532 nm, thiab cov ntaub so ntswg coagulation tob yog li 1 hli. Lub ntsiab kev phais mob rau kho prostatic hyperplasia yog qhov hu ua postate, kuj muaj vaporization ntawm prostate (pvp) [61-63].
Cov kev tshawb fawb pom tau tias kev ua tau zoo ntawm pvp hauv kev kho Bph tsis cuam tshuam ua ntej kev phais mob prostinit, lossis seb puas muaj keeb kwm ntawm kev tso zis ntawm kev tso zis (3]. Nws lub ntsiab tsis yog tias nws yog qhov tsis yooj yim sua kom tau txais kev txaus siab pathological cov qauv tom qab cov nqaij vaporization tom qab cov ntaub so ntswg.

4.2.3 thulium laser

Lub wavelength ntawm thulium laser tuaj yeem yog 1. 940-2. {{2 {2}}. 13 μm, yog li feem ntau yog hu ua 2 μm laser. Vim tias nws wavelength nyob ze rau lub zog nqus pa dej, nws tuaj yeem siv rau vaporization, vaporization txiav thiab encleation ntawm prostate [{}].
Cov ntaub ntawv tshawb fawb qhia tau tias cov txiaj ntsig ntawm prostate ua kom zoo ib yam li cov neeg mob Holep hauv kev phais laser tau ua haujlwm zoo rau kev kho mob BPH.

4.2.4 Diode lasas

Diode laser tseem hu ua liab laser lossis semiconductor laser. Nyob ntawm cov semiconductor, feem ntau nws yog siv rau vaporization thiab encleatation ntawm cov pretate nrog cov waveltints sib txawv xws li 940, 13870 nm [67-68]. Lub 980 nm wavelength tuaj yeem ua tiav qhov kev nqus tau zoo tshaj plaws hauv ob qho tib si ntawm kev siv hluav taws xob, thiab yog qhov ua tau zoo ntawm cov khoom siv nrawm thiab cov nyhuv "eschar" cov nyhuv ntawm thulium laser tsis tshua muaj. Cov tshuaj ntsiav anatomical ntawm lub prostate capsule kuj tseem pom meej dua, tab sis cov ntaub ntawv rov qab cov ntaub ntawv ntev tseem xav tau cov kev tshawb fawb tswj tau zoo.

Cov tshuaj ntsuab cistancey tshiab li cas rau prostate noj qab haus huv

4. 3 Hloov Bipolar Plasma ntshav

4. 3. 1 Hloov Bipolar Plasma Ua Yeeb Yam ntawm Kev Ua Ntej (Tupp)

Tupep yog cov txheej txheem uas ua ke kev phais mob ntawm kev phais mob uas prostate hy tev tawm ntawm cov tshuaj tiv thaiv prostule nrog cov ntiv tes. Cov riam ntawm resectoscope yog siv los ua tus ntiv tes, thiab lub tshuab bipolar ntshav muaj cov kev hemostasis zoo heev. Lub prostate hyperplasia glands yog maj peeled tawm raws prostate capsule under ncaj qha rau hauv lub zeem muag, thiab tshem tawm hauv tej daim. Cov txheej txheem no muaj cov yam ntxwv ntawm cov kev phais mob tsis txaus ntseeg nrog kev raug mob me me thiab yuav ua tiav qhov kev phais mob thiab tuaj yeem rov qab los ntawm kev phais tshiab. Nws muaj cov yam ntxwv ntawm kev tshem tawm ntau ntawm prostate hyperplasia cov nqi rov qab dua, thiab tsawg steraoperative los ntshav [69-70]. Nws kuj tseem siv tau rau cov neeg mob nrog bpph ntim> 80 ml. Nws cov nyhuv kho mob tsis txawv ntawm qhov ntawm cov turp, thiab nws tus nqi hloov chaw rau cov ntaub so ntswg thiab tus nqi tau yog siab dua li cov turp. Nws kuj tseem tuaj yeem nce cov kev nrhiav kom tau txais kev mob qog nqaij hlav prostate [71].

４. ３. 2 Kev hloov pauv hloov pauv thiab ua rau lub prostate (Tverp) thiab hloov pauv kev ua txhaum thiab ua rau muaj kev tawm tsam (TVE)

Tverp siv lub bipolar ntshav rab riam, thiab lwm yam ntshav tawm ntawm cov kua ntses postate caj pas. Cov txiaj ntsig ntawm kev tshawb fawb pom tias Todp muaj cov txiaj ntsig zoo ua ke, thiab tuaj yeem ua tiav "cov ntshav tsawg dua" lossis tsis muaj ntshav "kev phais ntshav. Tus neeg mob lub tso zis tam sim ntawd tom qab phais tas [72].
Ib qho ntxiv, txhawm rau kom luv luv lub sijhawm phais mob rau cov ntaub qhwv loj thiab cov kws tshawb fawb tau siv cov ntaub prostather kom tau txais pretate nqaij tom qab Tverp thiab muaj npe ordp.
TATP / TVEp tuaj yeem siv los ua kev xaiv kev ua haujlwm rau prostate hyperplasia, tab sis kev nyab xeeb ntev, tab sis ntev sib piv cov ntaub ntawv tseem xav tau cov tshuaj ntsuam xyuas ntxiv [{}].

4.4 Cov nyhuv ntawm kev phais rau ntawm kev sib deev

BPH cov neeg mob tseem ceeb rau cov pej xeem nruab nrab thiab cov laus, thiab cov neeg mob lawv tus kheej kuj muaj teeb meem muaj feem ntsig txog kev sib deev.
Kev phais mob Bph tau zoo, tab sis nws yuav ua rau muaj kev ntxhov siab, ua rau muaj kev sib deev, kev mob siab, txo qis Ejaculation, thiab lwm yam. [75-76].
Cov kev tshawb fawb tau pom tias cov teeb meem ntawm kev sib daj sib deev tom qab BPP kev phais mob yuav suav nrog:
① Kev tawm tsam ntau dhau los yog kev puas tsuaj rau cov ntaub so ntswg nyob ib ncig ntawm cov phev, sab nraud sphincter thiab bulbar urethra. Lub zais zis caj dab yog tam sim no ntseeg tias muaj cov nyhuv me me ntawm ejaculation muaj nuj nqi.
② Kev phais mob ua kom puas tsuaj rau erection-cuam tshuam cov ntshav thiab cov leeg.
Sental thiab kev puas hlwb [{77-79].
Theoretically, vim qhov txo cov luts thiab bp purph siv, tus neeg mob erectile muaj nuj nqi yuav tsum tau txhim kho tom qab phais piv nrog cov xwm txheej tsis txaus. Txawm li cas los xij, kev ncua ntu feem ntau tshwm sim hauv cov ntaub ntawv uas lub tshuaj ntsuab prostate tau txiav los ntawm kev phais mob lossis kev puas tsuaj ntau dhau los [80].

Kev sib deev tsis zoo tom qab BPH tom qab BPP feem ntau yog manifested li txawv txav kev ua haujlwm, ntawm uas retrogram rau feem ntau. Kev txheeb xyuas txoj kev ntsuam xyuas ntawm 30 Randomized tswj tau cov kev sim uas Retrograde eJaculation tom qab Turp yog 66.1% [81]. Line li al. [78] Kev tsom xam pom tias endoscopic prostatecy (ecep, ntshav prostatecy, thiab lwm yam) tsis txawv ntawm qhov tshwm sim ntawm Retograde Ejaculation. Tam sim no ntseeg tias txo cov ntaub so ntswg nyob ib ncig ntawm cov verumontanum thiab lub apex ntawm prostate tuaj yeem txhim kho ejaculation ua tom qab bph.

4.5 Kev Kho Mob ntawm Cov Teeb Meem

4.5.1 Kev Kho Mob ntawm Kev Ua Si Hauv Pob Hluav Taws Xob Hernia

Ua ntej kev phais mob, tus neeg mob yuav tsum tau kuaj xyuas qhov zoo tshaj plaws ntawm lub plab me me thiab ntsuas kev ua haujlwm ntawm tus neeg mob lub cev tseem ceeb. Tom qab kev tsom xam dav ntawm tus neeg mob, nws tau txiav txim siab txawm tias lub plab phais kab mob hernes Cov neeg mob uas tsis haum rau lub plab phab ntsa hernia phais tau pom zoo kom hnav hernia txoj siv. Nws yuav tsum raug sau tseg tias kev hnav ris tsho ntev yuav ua rau cov nplaum ntawm Hernia cov ntsiab lus rau Hernia SAC, thiab kev hnav tsis raug cai yuav ua rau muaj peev xwm ntawm Intermal Hernia.

Hais txog kev phais kab mob tshwj xeeb rau kev phais kab mob hernia thiab prostate hernia Tom qab phais tas, txoj kev phais ntawm lub plab phab ntsa hernia phais yuav tsum tau them nrog cov zaj duab xis tsis muaj kev txwv tsis pub muaj kev nkag siab tsis huv. Ib qho ntxiv, nws tsis pom zoo kom ua lub zais zis ci thiab fistula thaum phais prostate thiab paug rau cov zis ntxiv thiab ua rau kev phais mob siab.

4.5. 2 kev kho mob ntawm kev ua pauj

Bphrination nrog cov kev nruj me ntsis feem ntau yog tshwm sim los ntawm kev ua pauj rau yav dhau los lossis kev phais mob, thiab tsuas yog ib ob peb leeg yog qhov kev nruj me me ua ke nrog BPH. The patient's medical history should be carefully inquired to understand the occurrence and development of dysuria, and the cause of the patient's dysuria symptoms should be clarified. Rau cov neeg mob uas muaj kev tiv thaiv kev ua pauj, prostate phais yuav tsis haum. Cov ntsiab cai rau kev kho cov zis nruj hauv cov chaw sib txawv yog raws li hauv qab no.

4.5,2.1 Urethal orifice nruj me ntsis

Feem ntau ntawm cov ncauj lus ntau thiab o ntawm glans no, thiab qee qhov yog tshwm sim los ntawm kev phais mob siab yav dhau los thiab kev ua txhaum. Kev soj ntsuam urration nrog Urethral sojntsuam, urethral orifice orifice orifice illisice illaugis thiab lwm txoj kev kho tau, thiab kev txiav cai kuj tuaj yeem ua tau nyob rau tib lub sijhawm.

4.5.2.2 Teterior Urethal Kev Rho Tawm

Tso zis dilation nrog kev soj ntsuam nthwv dej urethral tsis pom zoo kom tsis txhob ua rau lub qhov zis thiab ua rau muaj kev tsis ncaj ncees. Nws raug nquahu kom ua Urethral dilation kev kho mob tom qab kev nkag siab txog qhov teeb meem tshwj xeeb hauv kev tawm tsam kev ua rau lub zeem muag tom qab ntxig qhov endoscope. Yog tias qhov ntev ntawm ntu nruj me ntsis yog tsawg dua 5 hli, nws raug pom zoo kom ua lub zeem muag txias kom tsis txhob muaj zog ua kom muaj zog ntau li ntau tau. Ceevfaj tsis txhob ua kom tob tob kom tsis txhob ua kom lub coraling cornusumsum thiab ua rau muaj ntshav hnyav. Yog tias qhov ntev ntawm txoj kev nruj ntev dhau thiab ntev dhau los, kev kho mob siab tawv yuav tsum tau ua ua ntej, thiab kev phais mob prostate ua ntej, thiab kev phais mob prostate

{{0 {0}}. {{{{}}. {} {} {}}}}} Posterior urethal urethal vericture

Membranous urethal nruj yog ze rau sab nraud urethal sphincter. Qeeb bununilation raug pom zoo rau qhov kev nruj no. Nws raug nquahu kom siv dilation nyob rau hauv lub zeem muag ncaj qha. Zam txhob siv kev ua phem ua rau kev puas tsuaj hauv zos. Ceev faj thaum phais neeg yog qhov tsim nyog. Txiav maj mam kom tsis txhob ua rau lub sphincter tsis zoo. Qhov kev phais txujcis yuav tsum tau tsuas yog rab riam txias los txo cov caij nyoog ntawm kev puas tsuaj thermal.

{{0 {}}. {５. 3 Kev Kho Mob Lub Pob Zeb Pluaj

Pob zeb zais zis yog ib txwm qhia rau kev phais mob ntawm bph. Tam sim no, muaj ntau cov kev kawm ntau ntawm kev phais mob pob zeb lub pob zeb Thib Ob txhais tau tias yog qhov txawv ntawm cov neeg yooj yim BPH. Txawm li cas los xij, qee cov kev tshawb fawb tau pom tias qhov tshwm sim ntawm lub sij hawm luv luv tso zis thiab tso zis ntau dua tom qab phais cov pob zeb thiab bph nyob rau tib lub sijhawm. Qhov kev phais mob uas tau nyiam rau lub zais zis tawg pob zeb litrotripsy nrog rau neprigation iprigation lossis hluav taws xob ua haujlwm). Rau cov neeg mob uas tsis tau phais ncua LithoTripsy, Qhib Kev phais mob Laparoscopic, thiab Extracorale Shock Wave Lithotripsy (ESWL) tuaj yeem ua tau. Qhib kev phais mob yog tshwj xeeb rau cov pob zeb loj heev rau cov pob zeb tshem tawm ntawm eswl yog tsawg. Bphrination nrog lub zais zis pob zeb yuav tsum tau ua raws li tom qab kev kho mob. Ntxiv nrog rau kev them nyiaj rau tus neeg mob tso zis thiab muaj qhov mob tso zis, nws yuav tsum tseem yuav suav nrog cov pob zeb lossis cov ntxeem tau rov qab los.

4.6 Lwm qhov kev kho mob tsawg tsawg

Rau cov neeg mob uas tsis tuaj yeem zam lub sijhawm ua kom ntev ntev lossis tsis tuaj yeem tiv thaiv kev puas tsuaj rau kev ua haujlwm sib deev, lawv tuaj yeem xaiv
Kev tiv thaiv kev ua mob siab rau peb, prostate dej vogrnation, prostate qhov kev phais mob, ua rau muaj kev sib cav sib ceg kev sim siab.