本文介绍应用Nd:YAG激光接触法治疗前列腺切除手术后的膀胱颈挛缩。50例病人平均年龄69岁,前列腺切除术后平均2.9年。均有排尿梗阻症状。44例(88%)为良性疾患,其中TURP41例,耻骨上前列腺切除3例;6例(12%)为前列腺腺癌,其中根治性耻骨后前列腺切除2例,TURP4例。所有病人均接受过膀胱颈扩张或切除治疗,尔后排尿梗阻症状复发。激光治疗前测量病人的尿流率,B超估计残余尿,局麻或加静脉镇静药后行膀胱镜检查,了解膀胱颈挛缩的程度。功率100～125W的Nd:YAG激光应用一个接触式光纤传导,光纤通过20F的膀胱镜鞘插入。激光输出功率在40-90W范围内,平均能量4950J(750～140000J),以环形方式作用于膀胱颈疤痕,直到可见的闭塞组织被汽化。术中注意用滤光眼镜保护病人及工作人员的眼睛。治疗结束后让病人排 This article describes the application of Nd: YAG laser contact treatment of bladder neck contracture after prostatectomy. The average age of 50 patients was 69 years and the average post-prostatectomy was 2.9 years. Have urination obstruction symptoms. Twenty-four patients (88%) were benign, of which TURP was performed in 41 cases and suprapubic prostatectomy was performed in 3 cases. Six cases (12%) were prostatic adenocarcinoma, including radical prostatectomy in 2 cases and TURP in 4 cases. All patients underwent bladder neck dilatation or resection, followed by voiding obstruction symptoms recurrence. Measurement of the patient’s urine flow rate before laser treatment, B-estimated residual urine, local anesthesia or intravenous sedative cystoscopy to understand the degree of bladder neck contracture. Nd: YAG laser with a power of 100 ~ 125W is applied with a contact optical fiber and the optical fiber is inserted through a 20F cystoscope sheath. Laser output power in the range of 40-90W, the average energy of 4950J (750 ~ 140000J), a ring-shaped role in the bladder neck scar until the visible occluded tissue is vaporized. Intraoperative attention to the use of filter glasses to protect the eyes of patients and staff. After treatment, let the patient row