摘要：经尿道前列腺电切术(transurethral resection of the prostate,TURP)为针对临床上药物治疗失败的良性前列腺增生(benign prostatic hyperplasia,BPH)患者的首选术式，其术后常见并发症之一为膀胱颈挛缩(bladder neck contracture,BNC)。术中对膀胱颈的过分切削、尿路感染、液体冲刷、机械应力等均为促进BNC的发病因素。TURP术后BNC的诊断需要依靠临床症状及必要的辅助检查，如膀胱镜检查等共同确定，术前合并慢性前列腺炎、小体积BPH、尿路感染、术中电切和电凝强度、术中操作、术后留置尿管等可作为BNC发生的重要预测因素。在药物治疗BNC总体效果不佳的情况下，应合理选择包括膀胱颈切开及膀胱颈重建在内的手术治疗。而术前对感染的控制及抗雄激素药物的合理应用、术中的精细操作、术后的通畅引流及糖皮质激素应用均可作为预防BNC的有效措施。

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良性前列腺增生专业防控联盟专家组.良性前列腺增生术后膀胱颈挛缩诊治专家共识[J]. 泌尿外科杂志（电子版）,2023,15(3):1-9. DOI:10.20020/j.CNKI.1674-7410.2023.03.01

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1 概述

2 发病机制

3 诊断标准

    3.1 病史

    3.2 临床症状

        3.2.1 尿液排出障碍

        3.2.2 血尿

        3.2.3 其他症状

    3.3 辅助检查

        3.3.1 影像学检查

        3.3.2 膀胱镜检查

        3.3.3 实验室检查

        3.3.4 症状量表

4 预测因素 

    4.1 术前BPH合并慢性前列腺炎

    4.2 小体积BPH

    4.3 尿路感染

    4.4 术中操作

    4.5 术后留置导尿管

    4.6 其他因素

5 治疗方式

6 预防措施

7 总结

对于TURP术后造成的医源性BNC目前仍缺乏一定的认识，多数患者在TURP术后发生BNC后因未能及时诊断，会错失治疗机会而造成二次入院治疗。因此，能够及时地诊断TURP术后BNC患者便显得尤为重要。本文简要概括了TURP术后BNC患者的临床症状与辅助检查的内容，旨为临床诊疗TURP术后BNC患者提供一定的依据。 

致谢： 执笔人：傅炜骁(北京大学第一医院泌尿外科)；王鉴冰(中国医学科学院，北京协和医学院八年制)；吴丽娜(中国医科大学附属盛京医院检验科)；袁育林(广西医学科学院，广西壮族自治区人 民医院检验科)；王山(中国人民解放军总医院医学创新研究部临床生物样本中心)；罗明(上海市第十人民医院泌尿外科)；田亚平(中国人民解放军总医院医学创新研究部出生缺陷防控技术研究中心)；许宁(福建医科大学附属第一医院泌尿外科)；宋刚(北京大学第一医院泌尿外科，国家癌症中心，国家肿瘤临床医学研究中心，中国医学科学院北京协和医学院肿瘤医院泌尿外科)

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