小切口联合经尿道前列腺电切术治疗前列腺增生合并膀胱结石

目的探讨前列腺增生症合并膀胱结石患者同期行膀胱取石和前列腺切除的临床效果。方法回顾性分析2000年9月～2004年6月我院32例采用小切口联合经尿道前列腺电切术(transurethralresectionoftheprostate,TURP)治疗前列腺增生合并膀胱结石的临床资料,腹壁小切口取出膀胱结石,利用此切口留置膀胱造瘘,再行TURP。结果32例均一次手术成功,取石率100%。手术时间45～120min,平均60min。术中出血量50～200ml,平均100ml。术后留置膀胱造瘘管2～3d,三腔气囊尿管3～7d。术后住院5～8d,平均6d。32例随访4～16个月,8例尿道狭窄,经尿道扩张后排尿正常,术后最大尿流率>15ml/s。结论对前列腺增生症合并膀胱大结石或多发结石患者,可首选小切口开放取石联合TURP。

Transurethral resection of prostate combined with mini-incision cystolithotomy for benign prostatic hyperplasia complicated with bladder stones

Objective To investigate the curative results of combined use of transurethral resection of the prostate (TURP) and suprapubic cystolithotomy in patients with benign prostatic hyperplasia (BPH) complicated with bladder stones. Methods A retrospective analysis was conducted on the clinical records of 32 cases of BPH complicated with bladder stones treated by TURP and mini-incision cystolithotomy in this hospital from September 2000 to June 2004. An abdominal small incision was made, and through the incision the bladder stones were removed and a suprapubic catheter was inserted. Afterwards, the TURP was carried out. Results The surgery was successfully accomplished on one session in all the 32 cases. The stone clearance rate was 100%. The operative time was 45~120 min (mean, 60 min). The intraoperative blood loss was 50~200 ml (mean, 100 ml). Postoperatively, the suprapubic catheter was left in place for 2~3 days, and the balloon catheter, 3~7 days. The length of postoperative hospital stay was 5~8 days (mean,6 days). The follow-up observations for 4~16 months in all the 32 cases found 8 cases of urethral stricture, which were cured by urethral dilatation (the maximal flow rate > 15 ml/s). Conclusions Combined use of mini-incision open cystolithotomy and TURP can be the first choice for the management of BPH complicated with large or multiple bladder stones.