前列腺增生合并膀胱结石的微创治疗

目的 总结前列腺增生(BPH)并膀胱结石的治疗方法及疗效.方法 回顾性分析112例BPH合并膀胱结石患者的临床资料及随访结果.结果 分别采用一期电切环直径勾出(11例)、大力碎石钳碎石(15例)、耻骨上经膀胱气压弹道碎石(9例)、经尿道气压弹道碎石(31例)、耻骨上小切口取石(24例)同期联合经尿道前列腺电切(TURP)和体外超声波碎石(ESWL)后TURP(22例)治疗.所有患者均一次性治疗成功,术中无膀胱及尿道穿孔、无发生经尿道电切综合征、输血及中转开放手术病例,无结石残留;术后6个月国际前列腺症状评分(IPSS)和最大尿流率(MRF)较术前有显著改善,无尿道狭窄及迟发出血等.结论 各种微创治疗均安全、满意.方法 选择应根据患者具体情况及结石大小综合分析,结合医疗条件及术者技能,采取个体化治疗措施.

Minimal invasive techniques for benign prostatic hyperplasia (BPH) combined with bladder calculi

Objectives To investigate the treatments and clinical effect for BPH combined with bladder calculi. Methods The clinical data of 112 cases of BPH combined with bladder calculi underwent minimal invasive techniques were reviewed retrospectively. Results Minimal invasive techniques were:combination of transurethral resection of the prostate(TURP) ,transurethral cystolithotripsy(n = 15) ,mini-incisions cystolithotomy(n =24),suprapubic ballistic lithotripsy (n = 9), transurethral ballistic lithotripsy (n = 31); extracorporeal shock wave lithotripsy(ESWL) and then TURP(n = 22). All the operations were successful ,there were no post-operation vesical perforation, no transurethral resection symptom (TU RS), no blood transfusion, no open surgery cases, no residual calculi, and no other severe complications. After a follow up of six months, the international prostatic symptom score (IPSS) and maximum flow rate(MFR) were significantly improved,urinary incontinence and calculi recurrence,delayed blood loss were not found. Conclusions Several minimal invasive techniques were safe and effective, the option is second to synthetic data of patient、diameter of calculi and medical apparatus and instruments.