Previous transurethral resection of the prostate is not a contraindication to high‐dose rate brachytherapy for prostate cancer

OBJECTIVE

To analyse retrospectively the morbidity and efficacy of high‐dose rate (HDR) brachytherapy in patients who had a previous transurethral resection of the prostate (TURP).

PATIENTS AND METHODS

Morbidities documented in the records of 32 patients with previous TURP and 106 with no previous TURP, treated with HDR brachytherapy for prostate cancer at our institution, were analysed and compared. All patients received HDR brachytherapy as a boost before conformal external beam radiotherapy. We recorded and analysed genitourinary complications, rectal morbidity, and the biochemical control rate as assessed by the prostate‐specific antigen (PSA) level.

RESULTS

All complications of patients who received HDR brachytherapy were recorded during the follow‐up. All gastrointestinal and genitourinary complications were not significantly different in patients with or without previous TURP. There was little incontinence or severe morbidity associated with HDR brachytherapy. The PSA‐based biochemical control rates were similar in patients with or without previous TURP in each risk group.

CONCLUSIONS

HDR brachytherapy is a reasonable treatment for localized prostate cancer in patients who have had a previous TURP, with the expectation of low morbidity and satisfactory biochemical control.     

经尿道电切术治疗女性膀胱颈梗阻12例

目的探讨经尿道电切治疗女性膀胱颈梗阻的疗效。方法对12例女性膀胱梗阻患者行径尿道膀胱颈电切术治疗,年龄51±13岁,病程3个月-5年,尿流率3.8±11.4ml／s,残余尿200-800ml术后随诊6个月以上。结果手术均获成功,手术时间15-50min,平均25min,术中出血〈20ml。12例患者排尿症状评分,最大尿流率平均18ml／s,残余尿均〈50ml。最大尿流率、残余尿量等均较术前显著改善,随访无尿失禁、尿瘘发生。结论经尿道电切术治疗女性膀胱颈梗阻疗效显著,并发症少。     

TURP术中霍姆对人体生理影响的研究

目的：研究TURP术中霍姆对人体CVP、Na、Cl、Ca、Hb、Hct等生理指标的影响。方法：选择TURP手术患者60例,随机分A、B两组各30例,A组为输霍姆组（250ml）,B组为输林格氏液组,观察两组间一般生命体征及CVP、Na、Cl、Ca、Hb、Hct的差异。既记录手术前（T0）、手术开始输霍姆前（T1）、霍姆输入完毕（T2）、输入霍姆后90min（T3）的结果进行分析比较。结果：两组间Na、Cl、Ca、Hb、Hct在T2时有显著差异,T3后恢复相近。结论：TURP术中输霍姆250ml可有效地防止TURS並发症的发生,有利于人体生理稳定。     

TURP术后前列腺偶发癌去势治疗的护理

总结21例TURP术后前列腺偶发癌去势治疗的护理。护理重点是去势术前做好心理指导,减轻患者的焦虑恐惧,做好术前皮肤清洁;术后保持切口局部清洁,服用氟他胺要告知药物的作用及不良反应,定期检查肝功能等。术后随访可以早期发现疾病的复发或转移,因此做好术后随访的指导很重要。     

经尿道前列腺等离子双极汽化电切术治疗前列腺增生的体会

目的观察经尿道前列腺等离子双极汽化电切术（TUPKVP）治疗前列腺增生（BPH）的临床疗效。方法采用英国Gyrus公司的等离子体双极汽化电切设备对56例BPH行经尿道前列腺汽化切除。结果手术均顺利,平均手术时间50min,平均切除前列腺62g,平均出血80ml,平均留置尿管时间4d;术后后期出血1例,未发生尿失禁、电切综合征（TURS）尿道狭窄等并发症。结论TUPKVP是目前治疗BPH理想的微创技术,疗效可靠,具有无手术切口、创伤小、痛苦少、术后恢复快、住院时间短等优点。     

四肢血液循环促进装置在食管癌术后的效果观察

目的观察气压式四肢血液循环促进装置在食管癌术后的使用效果。方法将82例食管癌术后患者用随机法将患者分为实验组和对照组,观察术后当天及次日患者术侧上肢的肢体酸痛程度和活动幅度。结果两组效果比较采用￡检验,差异有统计学意义。结论使用气压式四肢血液循环促进装置,有助于食管癌术后患者减轻术侧上肢肢体酸痛和增加肢体活动幅度。     

Economic Issues in the Treatment of BPH

The long-term cost of effective management for benign prostatic hyperplasia (BPH) remains an important issue in pharmacoeconomics because about 25% of men aged 50 yr and older experience voiding problems due to BPH. With the ageing population and the increase in the percentage of patients with BPH for whom any type of treatment can be considered, a substantial increase in total costs to society can be expected. The up-front costs of interventional approaches to BPH are being replaced by a pattern of long-term medical and preventive therapy. The age-adjusted rate of transurethral resection of the prostate (TURP) reached a high point in 1987 and TURP rates, but not costs, have been in decline ever since. Mean 1-yr treatment costs (medical therapy and TURP) have been estimated in a pan-European study to be 858 Euros per patient, 75% of which were medication costs. Using a 2-yr time frame for treatment, Medicare costs for finasteride, terazosin, and TURP have been estimated as $3874, $2161, and $1820, respectively. The available models of the total long-term cost for all therapies for BPH remain compromised by a lack of inclusion of indirect costs, the lack of true long-term data and, critically, the lack of human cost information (patient preference). Only medical therapy provides a preventive as well as symptomatic potential and, if all of the issues were fully incorporated, it is likely that medical therapy would be increasingly recognised as economically preferable.