良性前列腺增生合并膀胱结石同期处理的两种术式比较

目的比较良性前列腺增生（BPH）ff并膀胱结石同期处理的两种术式及疗效。方法63例患者随机分为两组．开放手术组（32例）采用经耻骨上小切口膀胱切开取石，再行经尿道前列腺电切术（TURP）。钬激光碎石组（31例）先经尿道钬激光碎石，再行TURP。观察两组患者术中取石时间、术后膀胱冲洗时间、留置导尿管时间、住院时间、住院费用及术后疗效。结果与钬激光碎石组比较，开放手术组术中取石时间、住院费用具有明显优势，两组差异均有统计学意义（t分别：2．89、17．87，P均〈0．05）；而术后膀胱冲洗时间、留置导尿管时间、住院时间比较，钬激光碎石组比开放手术组具有优势，两组差异均有统计学意义（t分别=2．21、8．04、2．19．P均〈0．05）。两组患者均一次取石成功。术后随访3—35个月，未见结石复发、尿失禁及尿道狭窄等并发症．国际前列腺症状评分（IPSS）、最大尿流率和残余尿量较术前均有显著改善。结论耻骨上小切口膀胱切开取石联合TURP、钬激光碎石联合TURP均可对BPH合并膀胱结石进行同期处理，是为安全有效的方法。

A comparative study of two means of simultaneous treatment for benign prostate hyperplasia and bladder stone

Objective To compare the safety and the clinical efficacy of two means of simultaneous treatment for benign prostate hyperplasia （BPH） and bladder stone. Methods Sixty-three cases of BPH and bladder stones were randomly divided into 2 groups： they were treated by combining mini-incisions cystolithotomy （group A） , transurethral eletroresection with holmium laser （group B）. TURP followed after the removal of stone. The removal of stone time, bladder irrigation time, catheterization time, hospital stay , hospital expenses and therapeutic effects were surveyed. Results Compared with group B, the removal of stone time, hospital cost were significantly superiority in group A（t=2.89,17.87, P〈0.05）.But compared with group A, the bladder irrigation time, catheterization time, hospital stay were significantly superiority in group B （t=2.21,8.0d,2.19, P〈0.05）. The procedures were successful in all cases, a follow up of 3 to 35 months found a good outcome in both groups. All the patients had normal micturation after the urethral catheter was withdrawn and no severe complication. IPSS, Qmax and RUV were significantly improved in both groups. Conclusion The results showed that the two therapies of BPH with bladder stones were safe and effective.