绿激光前列腺汽化联合腔内碎石治疗BPH并膀胱大结石

TREATMENT FOR BENIGN PROSTATIC HYPERPLASIA WITH BLADDER BIG STONES USING GREEN LIGHT PHOTOSELECTIVE VAPORIZATION OF PROSTATE AND ENDOSCOPE LITHOTRIPSY

[目的]探讨BPH并膀胱大结石的有效微创治疗方法。[方法]采用绿激光前列腺汽化术联合钬激光碎石术和膀胱大力碎石钳碎石术治疗BPH并膀胱大结石35例。[结果]35例均一次治疗成功。手术时间88～182min，平均96min，术后1—3d拔除尿管，排乐通畅，无电切综合征、膀胱穿孔等并发症。33例随访3个月到1年，国际前列腺症状评分（IPSS）和生活质量评分（QOL）由术前（25．3±6．2）及（5．3±0．9）分下降至术后（6．5±0.8）及（1．5±0．5）分；术后复查最大尿流率（MFR）均〉15ml／S。[结论]绿激光联合钬激光和大力碎石钳机械碎石治疗BPH并膀胱大结石安全、有效。

[ Objeetive] To explore the effective treatment for patients with benign prostatic hyperplasia （BPH） and bladder big stones. [ Methods] Green light photoselecfive vaporization of prostate （PVP） , holmium laser and mechanic lithotripsy were concomitantly performed on 35 patients of benign prostatic hyperplasia with bladder big stones. [ Results] Of all cases, BPH with bladder stones were successfully treated in one operation. Operative time ranged from 88-182min, average time 96rain. No patent experienced TUR syndrome or bladder rupture. All the patients had good vodding after urethral catheter was drawn 1-3days later. The 33 patients were followed up for 3 months to 1 year. IPSS zald QOL decreased from 25.3±6.2 and 5.3±0.9 to 6.5±0.8 and 1.5±0.5. The maximum flow rate （MFR） was over 15.0ml/s in all the postoperative results. [Conelusion] The combine use of PVP with endoscope lithotripsy is a minimum, effective and safe procedure for BPH with bladder big stones.