非肌层浸润性膀胱癌合并良性前列腺增生患者同期行经尿道电切手术的疗效和安全性分析

目的 探讨合并BPH的非肌层浸润性膀胱癌患者同期行经尿道电切(TUR)手术的疗效和安全性.方法 合并BPH的非肌层浸润性膀胱癌患者46例(A组)同期行TURBt和TURP治疗,非肌层浸润性膀胱癌仅行TURBt的男性患者69例(B组)作为对照组.A组年龄54～80岁,平均69岁;肿瘤单发37例、多发9例,肿瘤直径0.5 ～3.5 cm,平均2.8 cm.B组55～82岁,平均70岁;肿瘤单发54例、多发15例;肿瘤直径0.5～24.0 cm,平均2.9 cm;2组比较差异无统计学意义(P＞0.05).结果 2组均顺利完成手术.随访24 - 96个月,平均44个月.2组复发率分别为50.0％( 23/46)、50.7％ (35/69),首次无复发间期分别为20、18个月,肿瘤进展率分别为6.5％、7.2％,2组差异均无统计学意义(P＞0.05).A组术后发生前列腺窝内膀胱癌复发2例、B组l例,均为T1G3肿瘤.结论 同期行TUR手术治疗浅表性、低级别膀胱肿瘤合并BPH患者安全可行,但对于T1G3患者应慎重.

Clinical significance of simultaneous transurethral resection of a bladder tumor and the prostate in the treatment of non-muscle invasive bladder cancer with benign prostatic hyperplasia

Objective To evaluate the clinical significance of simultaneous transurethral resection (TUR) of a bladder tumor and the prostate in the treatment of non-muscle invasive bladder cancer with benign prostatic hyperplasia (BPH).Methods Patients were divided into two groups.Group A contained 46 male patients who accepted TUR for the treatment of both bladder cancer and benign prostatic hyperplasia.Group B contained 69 male patients who accepted TURBt only.Clinical data were retrospectively collected and analyzed to compare clinical outcomes and safety in these two groups.Results The bladder cancer recurrence rates in group A and B were 50.0％ and 50.7％,the average recurrence free time was 20 and 18 months,and the progression rates were 6.5％ and 7.2％,respectively.There were no significant differences between the two groups for either average recurrence free time or progression rates (P ＞ 0.05).Recurrences in the prostatic urethra were found in two cases in group A and one case in group B and all three cases were in T1 G3.Conclusions Simultaneous TUR for bladder tumor and the prostate can be safely and effectively performed in terms of oncologica] control in patients who have non-muscle invasive and low grade bladder tumors ( T1G1 - G2 ) with lower urinary tract obstruction caused by BPH.But this procedure should be cautiously performed on patients with T1 G3 bladder tumors.