前列腺增生并发较大膀胱结石的微创处理

Micro-Traumatic Treatment of Benign Prostate Hyperplasia Combined with Larger Bladder Calculi

目的探讨治疗前列腺增生(benign prostate hyperplasia,BPH)并发较大膀胱结石安全、高效的手术方法、疗效和经验。方法20例患者硬腰联合麻醉(combined spinal-epidural anesthesia,CSEA)后,采用经尿道前列腺汽化电切术(transurethral electrovaporization of the prostate,TURVP)加耻骨上小切口膀胱切开取石术(suprapubic lithotomy of the bladder,SCL)治疗BPH并发较大膀胱结石,并分析其疗效。结果所有患者均一次性治疗成功,无严重出血、电切综合症等严重并发症的发生,术后复查泌尿系平片、B超,膀胱内均无结石残留,清石率达100%。术后国际前列腺症状评分(in-ternational prostate symptom score,IPSS)平均8.5分。结论TURVP结合SCL是治疗BPH并发较大膀胱结石的一种安全、有良好效果的治疗方法。

Objective To investigate the safe and effective surgical method for benign prostate hyperplasia（BPH） combined with larger bladder calculi. Methods After combined spinal-epidural anesthesia, total 20 cases of BPH with larger bladder calculi were treated with transurethral electro-vaporization of the prostate（TURVP） and suprapubie lithotomy of the bladder. The post- operative outcomes were analyzed. Results All 20 eases were successfully treated. There were no serious complications such as residual calculi, serious bleeding, transurethral prostate resection syndrome（TURS） et al, occurred. The postoperative international prostate symptom score （IPSS） was improved obviously （ averages 8.5 ）. Conclusion TURVP with suprapubie lithotomy is safe and effective for BPH combined with larger bladder calculi.