经尿道电汽化术联合电切术治疗前列腺增生症122例

Combined use of transurethral vaporization and resection for benign prostatic hyperplasia: Clinical study of 122 cases

目的探讨经尿道前列腺电汽化术(transurethralelectrovaporizationoftheprostate,TUVP)联合经尿道前列腺电切术(transurethralresectionoftheprostate,TURP)治疗良性前列腺增生症(benignprostatichyperplasia,BPH)的效果。方法TUVP联合TURP治疗122例BPH。根据Rous提出的前列腺大小估重及分度法,Ⅰ度增生8例,Ⅱ度增生58例,Ⅲ度增生32例,Ⅳ度增生24例。结果手术时间20～140min,平均68min。术中出血量40～200ml,平均80ml。2例术后输血200ml,无前列腺电切综合征发生。平均留置尿管6d。122例随访4～19个月,平均10个月,国际前列腺症状评分由术前的(30.2±2.3)分降至术后(10.8±2.5)分(t=10.84,P=0.000),剩余尿量由术前的(252.6±65.3)ml降至术后的(35.6±10.4)ml(t=23.52,P=0.000),最大尿流率从(8.5±2.8)ml/s上升至(20.6±3.8)ml/s(t=6.67,P=0.000)。术后暂时性尿失禁2例,前尿道狭窄2例。结论联合应用TUVP及TURP治疗BPH疗效满意。

Objective To summarize the effect of transurethral vaporization of the prostate (TUVP) in combination with transurethral resection of the prostate (TURP) for the treatment of benign prostatic hyperplasia (BPH). Methods A combined use of TUVP and TURP was carried out for treating 122 cases of BPH. There were 8 cases of Rous stage Ⅰ disease, 58 cases of stage Ⅱ, 32 cases of stage Ⅲ, and 24 cases of Ⅳ. Results The length of duration of the operation was 20~140 min (mean, 68 min). The intraoperative blood loss was 40~200 ml (mean, 80 ml). A blood transfusion of 200 ml was required in 2 cases after the operation. No transurethral resection syndrome (TURS) occurred. The mean postoperative catheterization time was 6 days. All 122 patients had been followed for 4~19 months (mean, 10 months). The international prostate symptom score (IPSS) decreased from 30.2±2.3 pre-)operation to 10.8±2.5 post-operation (t=10.84,P=0.000); the residual urine (RU) decreased from 252.6±65.3 ml pre-operation to 35.6±10.4 ml post-operation (t=23.52,P=0.000); the maximum urinary flow rate (Qmax) increased from 8.5±2.8 ml/s to 20.6±3.8 ml/s (t=6.67,P=0.000). Postoperatively, transient urinary incontinence was observed in 2 cases, and anterior urethral stricture occurred in 2 cases. Conclusions Combined use of transurethral electrovaporization and resection of the prostate for the treatment of BPH gives satisfactory effects.