前列腺增生症并膀胱结石个体化治疗

Individualized treatment of benign prostatehyperplasia （BPH） complicated with bladder calculi

目的探讨前列腺增生症并膀胱结石的治疗方法。方法前列腺增生并膀胱结石180例，分别行膀胱小切口切开取石、气压弹道碎石、大力碎石钳碎石术，取石后均行TUVP术。结果本组180例手术顺利。术中术后无大出血及输血，无TURS发生，拔管后均排尿通畅，术后所有病例均随访6个月，患者术后Qmax、IPSS、QOL评分较术前显著好转（P〈0．01）。尿道狭窄6例，其中5例经尿道扩张治愈，1例经尿道内切开治愈；短期尿失禁9例，于4周内恢复控尿；无永久性尿失禁、无直肠或膀胱损伤、二次大出血、水中毒等并发症。结论选择个体化碎石取石处理既可提高碎石取石效率，又可减少术中术后并发症。

Objectives To investigate individual treatment of patients with benign prostate hyperplasia （BPH） complicated with bladder calculus. Methods Using pneumatic lithotripsy , cystolithotomy with mini - incision , lithotrite lithotripsy and transurethral vaporization of the prostate（TUVP） in 180 cases with bladder stones and benign prostatic hyperplasia. Results The operations completed successfully in all the cases with a mean lithoclasty time of 15 - 60minutes, and mean TUVP time of 85 minutes （ 60 - 120 minutes）. No blood transfusion, transurethral resection syndrome （TURS）, bladder perforation, or residual stone occurred during and ＇after the operations. Urethral catheter was withdrawn 5 -7days postoperation, while none of the patients had urinary incontinence or dysuria. The diagnosis of benign prostatic hyperplasia was confirmed by pathology examination. Six months after the operation , six patients occured urethral stricture. Conclusions Individualized treatment to patients with benign prostate hyperplasia （BPH） complicated with bladder calculus can raise efficiency of lithotripsy and reduce complications intraoperative and postoperative.