膀胱尿路上皮癌和前列腺增生症同期经尿道切除的安全性及生活质量评价

Safety and efficacy of simultaneous transurethral resection of bladder urothelial carcinoma and benign prostatic hyperplasia

目的评价膀胱尿路上皮癌(BUC)合并有良性前列腺增生(BPH)患者同期接受经尿道膀胱肿瘤切除术(TURBT)和经尿道前列腺切除术(TURP)的安全性和术后生活质量。方法 53例合并中重度BPH的BUC患者均来自南京江北人民医院,随机分为对照组接受TURBT+口服α受体阻滞剂或联合治疗组接受TURBT+TURP。术前接受国际前列腺症状评分(IPSS)和生活质量评分(QOL)评估,术后1年再评估,随访膀胱镜,对复发率和影响因素做比较分析。结果对照组与联合治疗组:总复发率分别为38%和33%(P>0.05),前列腺窝/膀胱颈(PF/BN)复发率分别为11%和14%(P>0.05);IPSS评分术前分别为23分和24分(P>0.05),术后分别为24分和20分(P<0.05);QOL评分术前分别为为3.8分和4.0分(P>0.05),术后分别为4.0分和3.1分(P<0.05)。多因素分析多发病灶对复发有影响意义,年龄和联合手术无影响意义。结论同期行TURBT和TURP是一种安全的手术,并不增加总的复发和前列腺窝/膀胱颈复发的风险,同时可以改善合并BPH的BUC患者术后生活质量。

Objective To evaluate the safety and quality of life of patients with non-muscle invasive bladder urothelial carcinoma(BUC)and benign prostatic hyperplasia(BPH)who received transurethral resection of bladder tumor(TURBT)and transurethral prostatectomy(TURP)at the same time.Methods A total of 52 BUC patients with moderate or severe BPH were randomly divided into two groups:the control group received TURBT+oral A receptor blocker,and the combined treatment group received TURBT+TURP.The International Prostate Symptom Score(IPSS)and quality of life score(QOL)were assessed before operation and 1 year after operation.The recurrence rate and influencing factors were analyzed and compared.Results There were no differences in total recurrence rate(33%vs.38%,P>0.05)and prostate fossa/bladder neck recurrence(PF/BN,11%vs.14%,P>0.05)between the combined treatment group and control group.The IPSS was 23 vs.24 before operation(P>0.05)and 24 vs.20 after operation(P<0.05).The QOL score was 3.8 vs.4.0 before operation(P>0.05)and 4.0 vs.3.1 after operation(P<0.05).Multivariate analysis showed that multiple foci had significant influence on recurrence,while age and combined operation had no significant influence.Conclusion Simultaneous TURBT and TURP are safe,which do not increase the risk of total recurrence and prostate fossa/bladder neck recurrence,but can improve patients'quality of life instead.