同期经尿道手术治疗浅表性膀胱癌合并良性前列腺增生的临床观察

目的 探讨经尿道膀胱电切术(transurethral resection of bladder,TURBt)同期进行尿道前列腺切除术(transurethral resection of prostate,TURP)治疗的浅表性膀胱癌合并良性前列腺增生(benign prostate hyperplasia,BPH)的临床效果.方法 回顾性分析本院手术治疗的109例浅表性膀胱癌合并BPH患者的资料情况,其中采取TURBt同期行TURP治疗的患者57例(联合组)、仅采取TURBt资料52例(对照组),对比两组患者的手术效果就围手术期指标.结果 联合组的手术时间、术中出血量、术后留置导尿管时间、术后住院时间均显著的长于对照组患者,且差异具有统计学意义(P＜0.05);术后联合组的国际前列腺症状(international prostate symptom score,IPSS)评分、生存质量(quality of life score,QOL)评分、残余尿量(residual urine volume,PVR)测定值均显著的低于对照组患者(P＜0.05),联合组的Q max测定值显著地高于对照组患者(P＜0.05);术后24个月,联合组和对照组的肿瘤复发率差异无统计学意义(P＞0.05),联合组的尿道狭窄发生率(3.51％)显著低于对照组患者(17.31％),且差异具有统计学意义(P＜0.05).结论 TURBt同期TURP治疗的浅表性膀胱癌合并BPH虽然手术时间、出血量较多及术后恢复时间长较单纯TURBt,但是具有显著的改善患者术后排尿情况、生存质量及降低尿道狭窄发生率的作用.

Transurethral resection surgery in treatment of superficial bladder cancer with benign prostate hyperplasia

Objective To investigate the clinical efficacy of transurethral resection surgery in treatment of superficial bladder cancer combined with benign prostate hyperplasia (BPH).Methods A retrospective analysis of 109 patients with superficial bladder cancer combined with BPH treated in our hospital was conducted.The patients were divided into 2 groups:combined treatment group (n =57) that patient undertook the treatment of transurethral resection of bladder (TURBt) and transurethral resection of prostate (TURP),and control group (n =52) that patients only had TURBt.The perioperative indicators were compared between the 2 groups.Results The operative time,blood loss,postoperative indwelling catheter time and hospital stay were longer in combined group than control group,and the difference was statistically significant (P ＜ 0.05).After operation,patients in combined group had significant lower marks compared with control group by evaluation of the International Prostate Symptom Score (IPSS),quality of life (QOL) score and residual urine volume (PVR) value (P ＜ 0.05).Qmax value of the combined group was significantly higher in patients (P ＜ 0.05).After 24 months of operation,the recurrence rate was not significant difference between two groups (P ＞ 0.05).In combined group,the incidence of urethral stricture was 3.51％,which was much lower than that in control group (17.31％).The obvious difference was statistically significant (P ＜0.05).Conclusion Compared to TURBt treatment alone,combined treatment had a longer operativeand postoperative recovery-time,and more bleeding in treatment of superficial bladder cancer combined with BPH.Nevertheless,combined treatment is beneficial for patients with relieved postoperative difficulty in voiding,improved quality of life and reduced incidence of urethral stricture.