经尿道钬激光碎石术联合1470 nm半导体激光前列腺气化术治疗良性前列腺增生症合并膀胱结石的效果

目的研究经尿道钬激光碎石术联合1 470 nm半导体激光前列腺汽化术治疗良性前列腺增生症(BPH)合并膀胱结石的效果。方法回顾性分析2016年1月至2018年1月在西京医院泌尿外科治疗的54例BPH合并膀胱结石患者的临床资料,根据治疗方式将患者分为A、B两组,各27例。A组采用经尿道气压弹道/超声碎石清石术联合前列腺等离子电切术治疗,B组采用经尿道钬激光碎石术联合1 470nm半导体激光前列腺汽化术治疗,比较两组患者IPSS评分、RUV、QOL评分及不良反应发生情况。结果手术后,两组患者IPSS评分、RUV均显著降低,且B组显著低于A组(P<0.05)。两组患者QOL评分均明显升高,且B组显著高于A组(P<0.05)。A组发生泌尿系感染4例、尿道狭窄4例,二次止血1例,B组未发生此类不良反应,A组患者不良反应总发生率显著高于B组(P<0.05)。结论与经尿道气压弹道/超声碎石清石术联合前列腺等离子电切术比较,经尿道钬激光碎石术联合1 470nm半导体激光前列腺气化术是一种安全高效的治疗良性前列腺增生症合并膀胱结石的方法。

Effect of transurethral holmium laser lithotripsy combined with 1470 nm semiconductor laser prostatic gasification in the treatment of benign prostatic hyperplasia with bladder stones

Objective To study the effect of transurethral holmium laser lithotripsy combined with 1 470 nm semiconductor laser prostatic gasification in the treatment of benign prostatic hyperplasia (BPH) with bladder stones.Methods The clinical data of 54 patients with BPH with bladder stones treated in urology department of Xijing Hospital from January 2016 to January 2018 were retrospectively analyzed.According to the treatment methods, the patients were divided into group A and B, with 27 cases in each group.The group A was treated with transurethral pneumatic lithotripsy/ultrasound lithotripsy combined with prostate plasma resection, the group B was treated with transurethral holmium laser lithotripsy combined with 1 470 nm semiconductor laser prostatic gasification.The IPSS score, RUV, QOL scores and occurrence of adverse reactions were compared between the two groups.Results After operation, the IPSS scores and the RUV of both groups significantly decreased, and those in the group B were significantly lower than the group A(P<0.05).The QOL scores of both groups significantly increased, and that in the group B was significantly higher than the group A(P<0.05).There were 4 cases of urinary tract infection, 4 cases of urethral stricture and 1 case of secondary hemostasis in the group A, and no such adverse reactions occurred in the group B, the total incidence of adverse reactions in the group A was significantly higher than that in the group B(P<0.05).Conclusion Compared with transurethral pneumatic lithotripsy/ultrasonic lithotripsy combined with prostate plasma resection, holmium laser lithotripsy combined with 1 470 nm semiconductor laser prostatic gasification is a safe and effective method in the treatment of BPH with bladder stones.