前列腺增生症并发腹股沟疝同期治疗两种不同术式比较

目的比较良性前列腺增生症（BPH）并发腹股沟疝同期两种手术的优缺点。方法18例患者随机分为两组。第1组10例，先行TURP术，再行无张力腹股沟疝修补术。第2组8例，作耻骨上“V”型切口（tunerwar—wick切口），行耻骨上经膀胱前列腺摘除术（SPP）加传统疝修补术（巴西尼法）。观察两组患者术后膀胱冲洗时间、留置导尿管时间、住院时间及术后疗效。结果术后均平卧3～5d，并持续膀胱冲洗，TURP2—3d，开放性手术4～6d。TURP术后第4～5天拔除尿管，开放性手术术后11～14d拔尿管。第1组手术后住院时间为（7．21±0．60），第2组为（13．00±0．71），第1组明显低于第2组（P〈0．01）。随访3个月～5年，第2组例疝复发1例、尿失禁1例、手术均无切口感染。结论在BPH并发腹股沟疝的同期手术中，无张力疝修补术加TURP应为首选。前列腺大、有较大膀胱结石、髂关节强直、经济条件差患者应行经耻骨上“V”型切口行SPP加疝修补术。

A comparative study of two means of simultaneous treatment for benign prostate hyperplasia and and its complication inguinal hernia

Objective To compare two surgical means of simuhaneous treatment for benign prostate hyperplasia （BPH） and its complication inguinal hernia. Methods 18 cases of BPH were randomly divided into 2 groups, each of them have the complication inguinal hernia simultaneously. For the 10 cases of the first group,transurethral clectroresection of prostate （TURP） was carried out and then, tension -free repair was made to cure the complication inguinal hernia. For the 8 cases of the second group, the margin of＂ V＂ shape （ tuner - war - wick margin） was made above the pubis and suprapubic transvesieal prostateetomy（SPP） and traditional inguinal hemiorrhaphy （ Bassini way） were performed. The post - operative bladder irrigation time, catheterization time, hospital stay time and therapeutic effects were observed. Results After opera- tion, every patient lay on bed for 3 - 5 days and underwent continuous bladder irrigation. The bladder irrigation time was 2 - 3 days in the TURP group,and 4 -6 days in the open operation group. Catheters were removed 4 -5 days after operation in the first group, and 11 - 14 days in the second group. The hospital stay time was 7.21±0. 60 days in the TURP group,and 13. 00±0. 71 days in the open operation group. All paitents have been followed up for 3 months to 5 years ,there were one case of hernia recurrence and one case of urine incontinence in the second group. There weren＇t any wound infection in all patients. There were obvious differences between two groups（P 〈 0.01 ）. Conclusion To cure the BPH and concurrent inguinal hernia by simultaneous surgery, TURP adding mesh - plug tension - free repaie is the first choice. If a patient has big prostate gland, big vesieal calculus, rigidity of hip joint, or does＇t have enough money, SPP adding inguinal herniorrhaphy should be chosen.