钬激光碎石术和经尿道等离子体电切加剜除术治疗BPH并膀胱结石的探讨

目的：探讨BPH并膀胱结石的有效治疗方法，为临床治疗BPH并膀胱结石的一期腔内治疗提供参考。方法：回顾性分析钬激光碎石术和经尿道等离子体电切加剜除术治疗BPH并膀胱结石患者36例的临床资料。结果：36例均一次手术成功，碎石时间15～45min，平均26min前列腺电切时间45～150min，平均65min。术中术后均无输血，无电切综合征、膀胱穿孔、结石残留等并发症。术后3～5天拔除尿管，无排尿困难、尿失禁等。病理检查结果均为BPH。术后3个月，国际前列腺症状评分（IPSS）由（22．6±4．8）分降至（7．8±1．5）分（P〈0．05），最大尿流率（Qmax）由（6．3±2．5）ml／s升至（16．8±3．8）ml／s（P〈0．05）。结论：同期进行钬激光碎石术和经尿道等离子体电切加剜除术是一种治疗BPH并膀胱结石的高效、安全的方法。

Holmium: YAG Laser Lithotripsy Combined with Transurethral Plasmakinetic Vaporization of Prostate with Enucleation Technique for Benign Prostatic Hyperplasia Complicated with Bladder Stones

Objective： To explore an effective treatment for benign prostatic hyperplasia （BPH） complicated with bladder stones, and to provide valuable information for clinical treatment. Methods： The clinical data of 36 ca ses with BPH complicated with bladder stones treated by Holmium： YAG Laser lithotripsy combined with transurethral plasmakinetic vaporization of prostate（TUPKVP） with enucleation technique were reviewed retrospectively. Results：The operations were completed successfully in all the cases with a mean lithoclasty time of 26 min （ 15-45 min）, and mean TUPKVP with enucleation technique time of 65 min （ 45-150 min）. No blood transfusion, TUR syndrome, bladder perforation, or residual stone occurred during and after the operations. Urethral catheter was withdrawn 3-5 days postoperation, none of the patients had urinary incontinence or dysuria. The diagnosis of BPH was confirmed by pathology examination. 3 months after the operations, IPSS decreased from （22.6±4.8）to（7.8±1.5）（P〈0.05） ; maximum urinary flow rate increased from （7.3±2.5） ml/s to （16.8 ± 3.8） ml/s （P〈0.05）. Conclusions： The holmium： YAG laser lithotripsy combined with TUPKVP with enucleation technique seems to be an effective, safe, and economical treatment method for BPH complicated with bladder stones.