经尿道膀胱肿瘤电切术联合经尿道前列腺电切术治疗浅表性膀胱癌合并良性前列腺增生效果

Effect of Transurethral Resection of Bladder Tumor Combined with Transurethral Resection of Prostate for Treatment of Superficial Bladder Cancer with Benign Prostatic Hyperplasia

目的:研究经尿道膀胱肿瘤电切术和经尿道前列腺电切术治疗浅表性膀胱癌(SBC)合并良性前列腺增生(BPH)的临床效果。方法:选取2013年2月-2016年2月笔者所在医院SBC合并BPH患者92例,采用随机数字表法分为两组,各46例。观察组实施经尿道膀胱肿瘤电切术(TURBT)和经尿道前列腺电切术(TURP)治疗,对照组仅进行TURBT治疗,比较两组手术效果。结果:观察组手术时间、膀胱冲洗时间均明显长于对照组,术中出血量明显多于对照组,差异均有统计学意义(P<0.05);两组平均住院时间比较,差异无统计学意义(P>0.05);术后1年,两组PVR和IPSS较术前明显降低,Qmax较术前明显升高,且观察组PVR和IPSS均低于对照组,Qmax高于对照组,差异均有统计学意义(P<0.05);术后3年,观察组和对照组尿路梗阻发生率分别为4.35%和17.39%,肿瘤复发率分别为2.17%和8.89%,观察组尿路梗阻发生率低于对照组,差异有统计学意义(P<0.05)。结论:TURBT联合TURP治疗SBC合并BPH可有效改善下尿路症状,减少术后尿路狭窄发生,同时有可能降低膀胱癌复发风险,临床效果和安全性均值得肯定。

Objective:To study the clinical effect of transurethral resection of bladder tumor combined with transurethral resection of prostate for superficial bladder cancer(SBC)with benign prostatic hyperplasia(BPH).Method:From February 2013 to February 2016,a total of 92 patients with SBC combined with BPH in our hospital were randomly divided into two groups,46 cases in each group.The observation group was treated with transurethral resection of bladder tumor(TURBT)and transurethral resection of the prostate(TURP),the control group only underwent TURBT,and compared the surgical outcomes of the two groups.Result:The operation time and bladder irrigation time in the observation group were significantly longer than those of the control group,and intraoperative blood loss were significantly more than that of the control group,the differences were statistically significant(P<0.05).The average length of hospital stay were compared between the two groups,and the difference was not statistically significant(P>0.05).At 1 year after operation,PVR and IPSS in the two groups were significantly decreased than those before operation,and the Qmax was significantly increased than that before operation,and the PVR and IPSS in the observation group were lower than those of the control group,and the Qmax was higher than that of the control group,the differences were statistically significant(P<0.05).At 3 years after operation,the incidence of urinary tract obstruction in the observation group and the control group were 4.35%and 17.39%,respectively,and the tumor recurrence rates were 2.17%and 8.89%,respectively,and the incidence of urinary tract obstruction in the observation group was lower than that of the control group,the differences was statistically significant(P<0.05).Conclusion:TURBT combined with TURP to treat SBC with BPH can improve lower urinary tract symptoms and reduce postoperative urinary tract stenosis,and may reduce the risk of bladder cancer recurrence,clinical efficacy and safety are worthy of recognition.