经尿道气化加电切术治疗重度前列腺增生症

The combined use of transurethral electrovaporization and transurethral resection of large volume benign prostatic hyperplasia

目的：探讨重度前列腺增生症（BPH)的有效治疗方法。方法：采用经尿道前列腺电气化术（TUEVP）加经尿道前列腺电切术（TURP）联合治疗重度 BPH患者 90例。结果：手术时间 45-124 min，平均95 min，平均切除前列腺组织 39 g。1例发生电切综合征。术后24-96 h拔除导尿管，排尿均通畅。全部病例随访 3个月-2年，IPSS由术前平均30.8分下降至术后平均7.2分(P<0.001)，最大尿流率（Qmax）由术前平均5.1 ml/s升至术后平均16.7 ml/s(P<0.001)，剩余尿由术前平均420 ml降至术后平均10 ml。术后继发性出血３例(3.3%)，尿道狭窄２例（2.2%），暂时性尿失禁 2例（2.2%）,永久性尿失禁 2例（2.2%)。结论 ：TUEVP加TURP联合治疗 BPH兼有两者优点，是治疗重度 BPH的有效方法。

Purpose:To study the effect of the combined use of transurethral electrovaporization of the prostate (TUEVP) and transurethral resection of the prostate (TURP) in the treatment of large volume benign prostatic hyperplasia (BPH). Methods: TUEVP and TURP were concomitantly performed for 90 cases of large volume BPH. Results: The procedure was successful and the postoperative course uneventful in all patients .TUR syndrome occurred in one case. All patients had got normal voiding after removal of catheter 24-96 hours postoperatively.The patients had been followed up for 3 months to 2 years.IPSS decreased from30.8 preoperatively to7.2postoperatively (P<0.001)and Qmax increased from 5.1ml/s preoperatively to16.7ml/s postoperatively(P<0.001).Conclusions:This procedure had the advantages of both TUEVP and TURP and was safe and effective with fewer complications. It is believed that combined use of TUEVP and TURP be the ideal treatment for large volume BPH.