不同术式联合TUVP治疗前列腺增生合并膀胱结石的疗效观察

The different treatments combined with TUVP treated the benign prostate hyperplasia with bladder calculi

目的探讨前列腺增生合并膀胱结石的治疗方式及疗效。方法回顾性分析84例前列腺增生(BPH)合并膀胱结石的患者采用体外震波碎石(ESWL)、直视下膀胱镜碎石钳机械碎石(OMC)、耻骨上小切口膀胱切开取石(SCL)和气压弹道碎石术联合前列腺汽化电切术(TUVP)治疗的临床资料。结果12例采用SCL联合TUVP术治疗后恢复良好;16例采用ESWL联合TUVP治疗,其中2例碎石不全,2例并发严重膀胱出血,碎石后留置尿管;30例采用OMC联合TUVP治疗,其中2例发生膀胱穿孔,4例并发严重膀胱出血;26例采用气压弹道碎石术联合TUVP治疗患者均一次性手术成功,无结石残留、严重出血、TURS等严重的并发症的发生。结论气压弹道碎石联合汽化电切治疗BPH合并膀胱结石较其他术式简单,安全、高效。

Objective To investigate the different treatments of benign prostate hyperplasia （BPH） with bladder calculi and find the most effective treatment for patients with BPH complicated with vesical calculi. Methods A total of 84 hospitalized cases of BPH with bladder calculi were analyzed retrospectively. Results 12 cases of BPH with bladder calculi who were treated by small cut lithotomy （SCL） combined with Transurethral Vaporization--electrosection of prostate （TUVP） recovered without any complications; In 16 cases of BPH with Bladder calculi who were treated by extracorporeal shock wave lithotripsy （ESWL） combined with TUVP： 2 cases of them with uncompleted lithotomy; 2 cases with severious bladder bleeding need to be placed catheter after lithotomy. In the 30 cases who were treated by orthophoric mechanical cystoscopic lithotripsy （OMC） combined with TUVP, 2 cases of them happened vesical perforation, 4 cases of them complicated severious bladder bleeding; 26 cases of BPH with bladder calculi who were treated by Air - pressure ballistic ultrasonic lithotresis combined with TUVP were all successful, there were not severious complications as the vesical perforation, calculi remains, severious bladder bleeding and TURP syndrome. Conclusion The treatment of bladder calculi of BPH by Air - pressure ballistic ultrasonic lithotresis combined with TUVP is simple, safety and effective than ESWL, OMC and SCL combined with TUVP.