TURP结合TUVP治疗高危前列腺增生42例分析

COMBINED USE OF TRANSURETHRAL VAPORIZATION AND RESECTION FOR HIGH-RISK BENIGN PROSTATIC HYPERPLASIA:CLINICAL STUDY OF 42 CASES

目的探讨经尿道前列腺电汽化术(transurethral electrovaporization of the prostate,TUVP)联合经尿道前列腺电切术(transurethral resection of the prostate,TURP)治疗高危重度良性前列腺增生症(bengnprostatichyperplasia,BPH)的效果。方法TUVP联合TURP治疗42例BPH。根据sohlege手术危险分类:Ⅰ级25例,Ⅱ级17例。所有患者术前国际前列腺症状评分(IPSS)为24±2,最大尿流率为(3.0±2.2)ml/s。残余尿量120～360 ml。结果手术时间40～80 min,平均60.0min。4例术后输血300 ml,1例先兆前列腺电切综合征发生,平均留置尿管5.0 d。42例随访6～36个月,平均11.0个月,IPSS由术前平均(24±2)下降至术后平均(8±3),最大尿流率(Qmax)由术前平均(3.0±2.2)ml/s升至术后平均(13.0±2.6)ml/s。术后暂时性尿失禁2例。结论联合应用TUVP及TURP治疗高危重度BPH疗效满意。

Objective To evalutate the effect of transurethral vaporization of the prostate （TUVP） in combination with transurethral resection of the prostate（TURP） for the treatment of high - risk and severe benign prostatic hyperplasia （BPH）. Methods A combined use of TUVP and TURP was carried out for treating 42 cases of BPH. There were 25 eases of Sohlege stage Ⅰ disease, 17 cases of stage Ⅱ. Results The length of duration of the operation was 40 - 80 min（ mean,60 rain）. A blood transfusion of 300 ml was required in 4 cases after the operation. Transurethral resection syndrome（TURS） occurred in 2 cases. The mean postoperative catheterization stay was 5 days. All 42 patients had been followed up for 6 -36 months （mean, 11 months）. The international prostate symptom score （IPSS） decreased from （24 ± 2 ） prcoperation to （ 8 ± 3 ） postoperation. The maximum urinary flow rate （Qmax） increased from （3.0 ± 2.2） ml/s to （ 13.0 ± 2.6） ml/s. Postoperative transient urinary incontinence was observed in 2 cases. Conclusion Combined use of transurethral electrovaperization and resection of the prostate for the treatment of high - risk and severe BPH gave satisfactory effects.