经尿道同期电切非肌层浸润性膀胱癌合并前列腺增生

Effect of Simultaneous Transurethral Electrocision in Non-invasive Bladder Carcinoma with Prostatic Hyperplasia

【目的】探讨同期行经尿道膀胱肿瘤加前列腺电切术治疗非肌层浸润性膀胱癌合并前列腺增生的可行性及疗效。【方法】回顾性分析本院2003年4月至2007年8月期间65例非肌层浸润性膀胱癌并前列腺增生患者的手术方法,31例同期行经尿道膀胱肿瘤电切和前列腺电切术（A组）;34组单纯行经尿道膀胱肿瘤电切术（B组）。观察两组间膀胱癌的复发率,复发时间,复发肿瘤升级率及有无前列腺部尿道种植。【结果】所有患者均随访12-37个月（平均18.6个月）,A组随访13-37个月（平均19.8个月）,术后复发率35.5%,复发肿瘤升级9.7%。B组随访12-32个月（平均16.9个月）,术后复发率41.2%,复发肿瘤升级8.8%。两组均发生一例前列腺部尿道膀胱癌种植。两组间随访时间、复发率、复发时间、复发肿瘤升级率及前列腺部尿道种植率差异无显著性（P〈0.05）。【结论】同期行经尿道膀胱肿瘤加前列腺电切术治疗是一种安全、有效的治疗方法,不增加前列腺窝种植的风险,对膀胱癌术后复发无影响。

[Objective]To investigate the effect of simultaneous transurethral tumor resection and prostate electrocision in patients with non-invasive bladder carcinoma complicated with benign prostatic hyperplasia. [Methods] The clinical data from 65 patients with non-invasive bladder carcinoma complicated with prostatic hyperplasia in our hospital from April 2003 to August 2007 were retrospectively analyzed. Thirty- four patients （group B） underwent transurethral electrocision of bladder carcinoma alone and 31 patients （group A） underwent both transurethral prostate resection and transurethral bladder tumor resection simultaneously. The recurrence and progression rate, elapsed time to recurrence, and the recurrence rate in the prostatic urethra were determined and compared between the two groups. Statistical analysis was performed using the MannWhitney U and chi-square tests. [Results] The patients were followed up for at least 12 months （mean 18.6, range 12 to 37）. The average follow-up period was 16.9 months （range 12 to 32） for group B and was 19.8 months （range 13 to 37） for group A. The recurrence and progression rate for group B and A were 41.2% and 8.8%, 35.5% and 9.7%, respectively. Recurrence in the bladder neck and/or prostatic urethra developed in 1 patient in each group. No statistically significant differences were found between groups in terms of followup time, recurrence, progression, recurrence in the prostatic urethra, and elapsed time to recurrence. [Conclusion]Simultaneous transurethral prostate resection and transurethral bladder tumor resection for the treatment of patients with severe lower urinary tract symptoms complicated with superficial bladder tumor is safe and effective without recurrence in prostatic urethra and tumor relapse.