药物配合内镜下解剖性剜除孤立性前列腺结核1例

Anatomic evisceration of solitary prostatic tuberculosis under endoscopy combined with drugs(a case report)

药物配合内镜下解剖性剜除孤立性前列腺结核(solitary prostate tuberculosis,SPTB)是一种结合药物治疗和最小侵入性手术来治疗前列腺结核(prostate tuberculosis,PTB)的方法。本研究通过1例病例报告展示这一治疗策略的有效性和安全性。患者,66岁,老年男性,主诉有尿频、尿急、尿痛等前列腺炎症状,经过详细的体查和辅助检查,包括前列腺特异性抗原(prostate-specific antigen,PSA)检测、尿液分析、影像学检查及病理活检,确诊为SPTB。治疗方案分为2个阶段:首先,患者接受了持续3个月针对结核病的标准化药物治疗,减少病原体负荷和控制炎症。随后,为彻底清除病灶,通过内镜进入尿道解剖性剜除前列腺腺体,保留前列腺包膜和周围组织的结构和功能,手术顺利,术后患者恢复良好,排尿通畅,无尿失禁,无结核扩散表现。通过本病例报告表明,药物治疗配合内镜下解剖性剜除手术是一种治疗SPTB的有效方法。

The combination of medication and endoscopic anatomic resection for solitary prostate tuberculosis(SPTB)is a method that combines drug therapy with minimally invasive surgery to treat prostate tuberculosis(PTB).This study demonstrates the effectiveness and safety of this treatment strategy through a case report.The patient was a 66-year-old elderly male,presenting with symptoms of prostatitis such as frequent urination,urgency,and pain during urination.After a thorough physical examination and auxiliary tests,including prostate-specific antigen(PSA)testing,urinalysis,imaging studies,and pathological biopsy,the diagnosis of SPTB was confirmed.The treatment plan was divided into two stages.Firstly,the patient received a three-month course of standardized anti-tuberculosis medication to reduce the pathogen load and control inflammation.Subsequently,to completely eliminate the lesion,endoscopic access to the urethra was used to anatomically resect the prostate gland,preserving the structure and function of the prostate capsule and surrounding tissues.The surgery was successful,and the patient recovered well postoperatively with smooth urination,no urinary incontinence or signs of tuberculosis spread.This case report demonstrates that drug therapy combined with endoscopic anatomic resection is an effective method for treating SPTB.