前列腺增生症术后行前列腺癌根治术的临床观察

Retropubic radical prostatectomy after operation of BPH

目的:总结前列腺增生症术后行耻骨后前列腺癌根治手术的体会。方法:对11例经尿道前列腺电切、2例经耻骨上前列腺切除术后病理检查证实为前列腺癌的患者行耻骨后前列腺癌根治术,患者平均年龄65岁,TNM分期为T_(1a-b)4例,T_(1c)8例,T_(2b)1例。结果:13例平均随访2年,全部无瘤存活,1例发生尿道狭窄,1例发生轻度尿失禁,最大尿流率15～32ml/min,3例恢复性功能。结论:前列腺增生症术后前列腺尖部有一定程度粘连,在耻骨后前列腺癌根治术中,通过仔细解剖,采用保护耻骨前列腺韧带和膜部括约肌的方法,同样可获得满意的尿控效果。

Objective：To conclude the experience of retropubic radical prostatectomy after operation of BPH. Methods.. A total of 13 cases were performed retropubic radical prostatectomy for the diagnose of prostate cancer by pathology after prior operation of BPH. 11 cases of them received TURP and other 2 cases received suprapubic prostatectomy. The mean age is 65 years old, the stage of TNM as follow：4 cases are T1a-b ,8 cases are T1c ,and 1 case is T2b. Results：The mean follow up of all 13 cases is 2 years. All patients have a tumor free survive, 1 case is of urethral obstruction, one case is of slight urinary incontinence, the Qmax is 15-32 ml/min, 3 cases recover from sexual function. Concluslons：There are a litter bit adherences at prostate apex after operation of BPH. In the operation of retropubic radical prostatectomy, we can get satisfied urinary control effect by carefully anatomy to protect the puboprostatic ligament and membranous sphincter.