开放和微创对高危大体积前列腺增生合并膀胱结石的同期治疗比较研究

目的 比较开放与微创两种方法对高危巨大前列腺增生合并膀胱结石的同期治疗临床效果.方法 高危巨大前列腺增生合并膀胱结石患者77例,其中膀胱切开取石同时前列腺剜除术49例,同期气压弹道碎石加前列腺电切术28例.对比分析两组治疗的临床资料及随访结果,比较两组的治疗效果.结果 两组患者均一次手术成功.与微创组比较,开放手术组手...

Comparison of two surgical techniques for giant benign prostatic hyperplasia (BPH) combined with bladder calculi at high risk period

Objectives To compare the clinical features and results between open and minimal invasive technique in treating giant prostates combined with bladder calculi at high risk period. Methods Seventy-seven patients at high risk period suffered from giant prostates with bladder calculi underwent suprapubic lithotomy and prostatectomy ( n = 49 ) or combination of transurethral resection of the prostate and ballistic lithotripsy ( n = 28 ). The two approaches were evaluated and compared with data from intraoperation and postoperation. Results All the surgeries succeeded, For the open and minimal invasive techniques, the operating time was (53 ± 17 ) min and ( 138± 32 ) min, blood loss ( 218 ± 42 ) ml and ( 225 ± 35 ) ml, The bladder washing time ( 5. 1 ± 1. 7 ) d and ( 2.3 ± 1. 9 )d,catheterization time ( 10.3 ± 1.7)d and (7.2 ± 1.3)d,The average hospitalization( 13.5 ±2. 1 )d and(8.6 ±2.8 )d, the cost (5203 ± 12855 )yuan and ( 11218 ±2301 )yuan, respectively ;Compared with minimal invasive group, the operating time and hospital cost were significantly superiority in open group( p ＜0.01 ). But compared with open group,the bladder irrigation time,catheterization time,and hospital stay were significantly superiority in minimal invasive group ( p ＜ 0. 01 ). After a follow up of six months, the I PSS decreased from ( 28.6 ± 4.7 ) and ( 28.3 ± 4. 1 ) to (55.55 ± 1.4)and(5.6 ± 1.2) ,MFR from (5.6 ±0.5)ml/s and (5.7 ±0.6) ml/s to(23.3 ±9.5) ml/s and(22.4± 8.9 )ml/s, respectively. All of them were significantly improved in both groups, but no significantly difference between two groups. minimal invasive technique had 5 TURS,2 bled postoperation,2 urethremphraxis,2 urinary tract infection;The open treats had 3 urethremphraxis,2 urinary tract infection. Conclusions Although minimal invasive technique had quicker recovery, but operating time were longer, complications in intraoperation and postoperation didnt less than Open surgery;So open surgery is still a feasible treatment option for patients suffered from a giant prostate with bladder calculi for which has the benefit of a short operating time, less complications of TURS, and less cost for treatment.