经尿道前列腺汽化电切术治疗晚期前列腺癌致后尿道梗阻

Transurethral electrovaporization for urethral obstruction in advanced prostatic cancer

目的：探讨经尿道前列腺汽化电切术对晚期前列腺癌致后尿道梗阻的治疗作用。方法：对22例晚期前列腺癌致后尿道梗阻患者采用经尿道前列腺汽化电切术（TUVP＋TURP）加双侧睾丸切除术和术后氟他胺口服治疗。结果：经尿道前列腺汽化电切术切除前列腺组织12～45g，平均（23．23±6．90）g。术后均一次性解除后尿道梗阻，最大尿流率从术前（6．38±2．04）mL／s升至（14．15±1．95）mL／s，残余尿从术前平均125mL减少至20mL。国际前列腺症状评分从术前（29．54±3．19）分降至（8．54±1.58）分。生活质量评分从术前（5．35±0．63）分降至（1．15±0．37）分。术前后各参数值比较，P值均〈0．05。结论：晚期前列腺癌致后尿道梗阻，在雄激素阻断治疗的同时，加用经尿道前列腺汽化电切术治疗，可有效、迅速改善后尿道梗阻症状，对提高患者生活质量有明显作用。

Objective To evaluate the application of transurethral electrovaporization in treatment of urethral obstruction of the patients with advanced prostatic cancer. Methods From March 2001 to October 2004, 22 cases of prostatic cancer were treated by transurethral electrovaporization plus bilateral orchidectomy plus postoperative endocrine therapy with oral flutamide. Results The procedure was successful and the weight of prostate tissue resected was 12-45 g, average （23.23±6.90）g. All the patients got satisfactory micturation. The maximum flow rate was elevated from （6. 38±2.04） to （14. 15±1. 95） mL/s,the average residual urine was decreased from 125 mL to 20 mL. International prostate symptom score dropped from （29.54±3. 19） to （8. 54±1. 58）, quality of life score dropped from （5. 35±0. 63） to （1.15±0.37） （P〈0.05）. Conclusion To treat urethral obstruction of the patients with advanced prostatic cancer by transurethral electrovaporization plus androgen ablation therapy can get stable and effective medical results.