前列腺等离子剜除术联合钬激光碎石术治疗良性前列腺增生合并膀胱结石的疗效分析

The efficacy of plasma kinetic enucleation of the prostate combined with holmium laser lithotripsy in the treatment of benign prostatic hyperplasia with bladder stones

目的探讨经尿道等离子前列腺剜除术(PKEP)联合钬激光碎石术治疗良性前列腺增生(BPH)合并膀胱结石的效果。方法选取我院BPH合并膀胱结石患者81例,根据治疗方案不同分为经尿通前列腺电切术(TURP)组46例和PKEP组35例,比较两组治疗效果及并发症发生情况。结果 PKEP组手术时间、术中出血量、膀胱冲洗时间、导尿管留置时间及住院时间均少于TURP组(P <0. 05);术后3月,两组国际前列腺症状评分(IPS)、生存质量评分(QOL)及残余尿量(RUV)明显降低(P <0. 05),Qmax明显升高,且PKEP组IPSS评分、QOL评分及RUV低于TURP组,Qmax高于TURP组(P <0. 05);两组国际勃起功能指数-5(IIEF-5)评分升高,勃起功能障碍(ED)发生率降低,且PKEP组IIEF-5评分高于TURP组(P <0. 05),两组术后ED发生率比较差异无统计学意义(P> 0. 05);TURP组并发症发生率高于PKEP组(P <0. 05),两组结石残留率比较差异无统计学意义(P> 0. 05)。结论 PKEP联合钬激光碎石术治疗BPH合并膀胱结石可有效缩短手术时间,减轻尿道及周围结构损伤,提升手术效果并减少术后并发症。

Objective To investigate the effects of plasma kinetic enucleation of the prostate(PKEP)combined with holmium laser lithotripsy in the treatment of benign prostatic hyperplasia(BPH)with bladder stones.Methods Eighty-one patients with BPH and bladder stones in our hospital were retrospectively analyzed.According to different treatment regimens,the patients were divided into transurethral resection of prostate(TURP)group(N=46)and PKEP group(N=35).The treatment effects and occurrence of complications were compared between the two groups.Results The operative time,intraoperative blood loss,bladder irrigation time,catheter indwelling time and hospital stay in the PKEP group were all less or shorter than those in The TURP group(P<0.05).After 3 months of operation,IPSS score,QOL score and RUV in the two groups were significantly decreased(P<0.05)while the Qmax was significantly increased(P<0.05),and IPSS score,QOL score and RUV in the PKEP group were lower than those in the TURP group while Qmax was higher than that in the TURP group(P<0.05).IIEF-5 scores were significantly increased in the two groups(P<0.05),and the incidence rate of ED was significantly decreased(P<0.05),and IIEF-5 score in the PKEP group was higher than that in the TURP group(P<0.05).There was no significant difference in the incidence rate of postoperative ED between the two groups(P>0.05).The incidence rate of complications in the PKEP group was higher than that in the TURP group(P<0.05).There was no significant difference in stone residual rates between the two groups(P>0.05).Conclusion PKEP combined with holmium laser lithotripsy for BPH with bladder stones can effectively shorten the operative time,reduce the damage of urethra and surrounding structures,improve the surgical results and reduce the postoperative complications.