良性前列腺增生症合并膀胱结石患者不同腔道手术方案研究

目的:探讨前列腺增生合并膀胱结石患者同期行经尿道前列腺电切术联合钬激光或大力碎石钳碎石取石术的可行性，同时比较2种碎石方式的差异性。方法：采用随机对照单盲临床试验设计，将43例前列腺增生合并膀胱结石患者随机分为联合大力碎石钳组（20例）和联合钬激光组（23例），分别施行经尿道前列腺电切术联合钬激光碎石取石术及经尿道前列腺电切术联合大力碎石钳碎石取石术，比较2组患者手术前后IPSS评分、最大尿流率、碎石成功率、碎石时间、手术并发症。结果：2组患者均无电切综合征和结石残留等并发症发生，排尿通畅。直径>2 cm的结石，联合钬激光组的碎石效率和成功率较联合碎石钳组有明显优势，差异有统计学意义(P<0.05)。直径<2 cm膀胱结石，2种方式在碎石效果方面无差异（P > 0.05），故直径>2 cm膀胱结石，钬激光推荐首选。结论：前列腺增生合并膀胱结石患者同期行经尿道输尿管镜膀胱结石钬激光碎石取石术，不增加合并症，是一种安全、有效的治疗方法。

Investigation of endourlogical operation in treating BPH and bladder calculus

Objective: To evaluate the feasibility of transurethral resection of the prostate combined with Ho:YAG laser or lithotrite lithotripsy of bladder stones for treatment of patients with bladder stones and BPH. Then to compare the therapeutic effects of the two methods. Methods: A single-blind, randomized controlled trial was adopted. The clinical data of 43 cases of patients with bladder stones and BPH were retrospectively reviewed . including 20 cases treated with TURP and lithotrite and 23 cases treated with TURP and Ho:YAG laser. The perioperative indicators before operation or after operation were compared in the two groups. Results: All patients this team rehabilitated smoothly, no complications were observed ,No TUR syndrome，or residual stone occurred during and after the operations. Maximum urinary flow rate was apparently increased. There were remarkable differences in lithotripsy success rate between two groups (P<0.05)．There were also remarkable differences between in lithotripsy success rate and efficiency between two groups, when the diameter is move than 2cm. The therapeutic effects of the two lithotripsies is the same when the diameter of the bladder calculus is less than 2cm . when the diameter is more than 2cm,Ho:YAG laser lithotripsy is more effective than lithotrite．Conclusion: Our data indicate that simultaneous TURP and Transurethral Ho:YAG laser lithotripsy of bladder stones do not increase the complication, and is safe and effective alternative treatment.