经尿道前列腺电切联合小切口膀胱取石术治疗BPH并膀胱结石

Combined Transurethral Resection of Prostate and Mini-incision Percutaneous Cystolithotomy for Benign Prostatic Hyperplasia and Bladder Stones

目的:探讨BPH合并膀胱结石进行同期治疗更为有效的方法。方法:采用TURP联合经皮小切口卵圆钳膀胱取石术治疗BPH合并膀胱结石患者25例。即在电切镜监视引导下,将卵圆钳经耻骨上小切口插入膀胱腔内取石,再行TURP。结果:25例均一次手术成功,取石率100%,手术时间35～90 min,平均65 min,其中取石时间3～15 min,平均7 min;术后留置膀胱造瘘管1～3天,留置尿管3～5天;术后住院时间5～8天,平均6.2天。术后随访3～26个月,无结石复发,Q_max>1 5 ml/s。结论:TURP联合小切口卵圆钳膀胱取石术治疗BPH合并膀胱结石,具有取石时间短、创伤小、操作简单及安全有效等优点,尤其适合膀胱较大结石或多发结石患者。

Objective： To investigate more effective treatment of patients with benign prostatic hyperplasia （BPH） and bladder calculi. Methods：25 patients with BPH and bladder calculi underwent combined transurethral resection of prostate （TURP） and mini-incision pereutaneous eystolithotomy with sponge forceps. With the patient in the lithotomy position, sponge forceps was introduced into the bladder through the suprapubie mini-incision, and bladder stones were intactly extracted with sponge forceps under rectoscope guidance. This was followed by TURF. Results：The procedure was successful in all 25 patients with complete stone clearance achieved. The mean operating time was from 35 to 95 minutes （mean, 65 rain）, and the average operating time for stone extraction was 7 minutes （range 3 to 15 min）. The suprapubic catheter was removed 1-3 days, and the urethral catheter was removed 3-5 days postoperatively. The mean postoperative hospital stay was 6.2 days （range 5 to 8 days）. The follow-up was from 1 3 to 26 months, no stone recurrence was observed in all 25 patients, and the maximum flow rate 〉 15 ml/s. Conclusions： Combined transurethral resection of prostate and mini-incision percutaneous cystolithotomy with sponge forceps has been shown to be easy to perform, and a quick, safe and effective, minimally invasive procedure for BPH and bladder calculi, especially for patients with large or multiple bladder stones.