70岁以上老年人前列腺增生症合并膀胱结石的腔内手术效果评价

Evaluation of the endourological treatment of BPH with bladder stones in the elderly over 70 years

目的评价70岁以上老年人前列腺增生症(BPH)合并膀胱结石腔内手术治疗的效果和安全性。方法回顾性分析37例70～89岁患者经尿道前列腺切除术(TURP),同时行气压弹道碎石术的临床资料和随访结果。结果所有患者均一次处理成功,平均手术时间80min,平均术中出血90mL,术中和术后无膀胱穿孔、水中毒和危及生命的并发症发生。随访3～18个月,未见结石复发及尿失禁、尿道狭窄等并发症,国际前列腺症状评分(IPSS)、最大尿流率和残余尿量较术前均有显著改善。结论70岁以上老年人同期施行TURP和气压弹道碎石术的手术是安全的,效果是满意的。

[Objective] To evaluate the endourological treatment of benign prostatic hyperplasia （BPH） with bladder stone in the elderly over 70 years. [Methods] Clinical data of 37 patients 70-89 years old underwent simultaneous transurethral resection of prostate （TURP） and pneumatic lithotripsy from July 2002 to May 2006 were retrospectively analysed and followed up. [Results] The operations were successful in all of the patients, the mean operating time was 80 minutes, the mean blood loss was 90mL. No postoperative vesical perforation, water intoxication and life threatening complications were noted. No recurrence of stones, no urethral stenosis or other complications had occurred after a median follow-up of 10 months （range 3 to 18）. I-PSS, maximal flow rate and residual urine were evidently improved after operation. [Conclusions] The combination of TURP and pneumatic lithotripsy is a practical, safe and effective approach for the elderly patients.