电切镜下同期治疗BPH并发膀胱结石疗效观察

目的：探讨BPH并发膀胱结石更为有效的治疗方法.方法：采用TURP联合电切镜下钬激光碎石术同期治疗BPH并膀胱结石患者23例,即通过电切镜电切攀通道置人经过裁剪的输尿管导管及钬激光光导光纤行膀胱结石钬激光碎石,冉行TURP.结果：23例均一次性手术成功,取石率100%,手术时间30～80 min,平均56 min,其中碎石时间3～20 min,平均9 min 术中无膀胱穿孔、膀胱出血、TURS 术后留置导尿3～5天,术后住院时间4～9天,平均5.6天 术后随访3～18个月.无结石复发,无尿道狭窄.结论：采用TURP加电切镜下钬激光碎石术治疗BPH并膀胱结石具有手术时间短、创伤小及安全等优势,能够治疗膀胱较大结石、多发结石,对治疗伴有膀胱出血患者更显优势.

Simultaneous Management of Benign Prostatic Hyperplasia with Bladder Calculi Through Resectoscope

Objective：To explore the effective treatment of patients with benign prostatic hyperplasia （BPH） and bladder calculi. Methods： 23 patients with BPH and bladder calculi underwent combined transurethral resection of prostate （TURP） and transurethral cystolithotripsy with holmium laser through resectoseope. Tailored ureteral catheter and Optical fiber of holmium laser was introduced into the bladder through the aisle of resectoscope, and cystolithotripsy with holmium laser. This was followed by TURP. Results：The procedure was successful in all 23 patients with complete stone clearance. The mean operating duration was from 30 to 80 minutes（mean, 56min）, and the average operating duration for stone extraction was 9 minutes （range 3 to 20 min）. No bladder perforation, no bladder bleed, no TURS was found. The urethral catheter was removed 3-5 days postoperatively. The mean postoperative hospital stay was 5.6 days （range 4 to 9 days）. The follow up was from 3 to 18 months, neither stone recurrence nor urethral stricture were observed in all 23 patients. Conclusions： Simultaneous management for benign prostatic hyperplasia with bladder calculi through reseetoseope has been shown to be easy to perform, and a quick, safe and effective, minimally invasive procedure. It also can be used to deal with large or multiple bladder stones, especially for patients with bladder bleeding.