TURP联合钬激光碎石术治疗前列腺增生并发膀胱结石的疗效观察

TURP combined holmium laser lithotripsy in treatment of benign prostatic hyperplasia complicating bladder calculi

目的探讨经尿道前列腺电切(TURP)联合钬激光碎石治疗前列腺增生并发膀胱结石的临床疗效。方法回顾性分析2007年10月至2012年9月采用TURP联合输尿管镜钬激光碎石术治疗前列腺增生并发膀胱结石65例患者的临床资料。结果 65例患者均一次手术治疗成功,术后B超复查,膀胱内均未见结石残留,清石率达100%。术中、术后无大出血,无膀胱穿孔和前列腺电切综合征等并发症。58例术后获随访3～12个月,无结石复发,国际前列腺症状评分(IPSS)、生活质量评分(QOL)、最大尿流率(Qmax)以及残余尿量(RUV)均有明显改善,与术前比较,差异均有统计学意义(P<0.01)。结论 TURP联合输尿管镜钬激光碎石术治疗前列腺增生并发膀胱结石具有创伤小、恢复快、安全高效、并发症少等优点,是治疗前列腺增生并发膀胱结石的一种较理想的方法。

Objective To explore the effect of transurethral resection of the prostate （TURP） combined with holmium laser in treating benign prostatic hyperplasia complicating bladder calculi. Methods The clinical data in 65 patients with benign prostatic hyperplasia complicating bladder calculi treated by TURP combined with holmium laser lithotripsy from October 2007 to September 2012 were retrospectively analyzed. Results 65 cases were successful in once surgery. Postoperative B-type ultrasound reexamination showed no residual stones within bladder,with stone clearance rate of 100%. No intraoperative and postoperative bleeding, perforation of the bladder and TURP syndrome and other complications occurred. 58 eases were followed up for 3-12 months, no stone recurred. Compared with before operation, the International Prostate Symptom Score （IPSS）, quality of life score（QOL） ,maximum urinary tlow rate（Qmx） and the residual urine volume（RUV） after treatment were significantly improved with statistical difference （P〈0.01）. Conclusion TURP combined with holmium laserlithotripsy in the treatment of benign prostatic hyperplasia complicating bladder calculi has the advantages of less trauma, quick recovery, security, high efficiency and fewer complications, and is an ideal method for treating benign prostatic byperplasia complicating bladder calculi.