良性前列腺增生合并膀胱结石的腔内治疗

Intracavitary therapy for benign prostatic hyperplasia with bladder stone

目的:探讨气压道道/超声碎石术和经尿道前列腺汽化电切术治疗前列腺增生(BPH)合并膀胱结石的治疗效果。方法:采用瑞士气压弹道/超声碎石清石系统(lithoclast Rmaster)和经尿道前列腺汽化电切设备治疗前列腺增生合并膀胱结石43例。结果:41例一次手术成功,手术中碎石时间15～60 min,平均32 min;前列腺电切时间50～110 min,平均85 min。术中术后均无输血,未发生前列腺电切综合征、膀胱穿孔等并发症。术后5～6d拔除尿管,未发生排尿困难、尿失禁等。病理结果均为良性前列腺增生(BPH)。国际前列腺症状评分由术前(21.4±2.06)分下降至术后(7.4±1.2)分(t=2.182,P<0.05),最大尿流率由术前(6.37±1.96)ml/s升至(19.05±1.95)ml/s(t=29.990 4,P<0.000 0),生活质量评分由术前(4.76±0.94)分术降至为(2.25±0.75)分(t=13.626,P<0.000 0)。结论:气压弹道/超声碎石术和经尿道前列腺汽化电切术能有效治疗BPH合并膀胱结石。

Objective：To explore the effective treatment for benign prostatic hyperplasia （BPH） with bladder stone. Methods： Swiss lithoclast master and thansurethral resection of prostate （TURP） were performed on forty three patients of BPH with bladder stones. Result： Forty one cases were successfully treated in first operation, lithoclasty was the average time of 32 min; and the average time of TURP was 85min. there were no blood transfusion during operation or after operation, and no patients had TURP syndrome, bladder perforation. All the patients had normal micturition after five or six days urethral catheterization. No patients had urinary incontinence or dysuria. All cases were testified by pathologic examination. The forty one patients were followed up for two months to one year. The international prostate symptom score （IPSS） decreased from （21.4±2.06） to （7.4±1.2） score; The quality of life （QOL） decreased from （4.76±0.94） to （2.25±0.75） score;the maximum flow rate was improve from （6.37±1.96）ml/s to （19. 05±1. 95） ml/s in all the postoperative. Conclusions： The combined of EMS lithoclast master and TURP has minimum invasion and optimal treatment for BPH with bladder stones.