经尿道汽化电切加电切术治疗前列腺增生症(附256例报告)

目的　探讨良性前列腺增生症(BPH)的有效治疗方法。方法　采用经尿道前列腺汽化电切(TUEVAP)加经尿道前列腺电切术(TURP)联合治疗BPH患者256例。结果　手术时间20～125min，平均62min。29例(11.3%)术中需输血200～600ml，均为Ⅲ°增生者。切除前列腺组织重量8～120g，平均38g。无电切综合征发生。术后3～5d拔除导尿管，排尿均通畅。180例随访6个月～2年，IPSS由术前28.8±2.0下降至术后7.2±0.3(P<0.01)，最大尿流率由术前平均(5.1±0.4)ml/s升至术后(16.7±1.8)ml/s(P<0.01)。B超复查124例，38例(30.7%)仍有剩余尿10～40ml，平均18.2ml。术后继发性出血12例(4.7%)，尿道狭窄8例(3.1%)，暂时性尿失禁3例(1.2%)。结论　TUEVAP加TURP联合治疗BPH可综合两者的优点，疗效显著，并发症少，安全性高，是治疗BPH的有效方法。

The combined use of transurethral electro-vaporization ablation and transurethral prostatectomy for BPH(report of 256 cases)

Objective　To study the availability of the combined use of transurethral electro-vapo- rizationablation of the prostate (TUEVAP) and transurethral prostatectomy in the treatment of benign prostatic hyperplasia(BPH).Methods　TUEVAP and transurethral prostatectomy(TURP)were concomitantly performed for 256 cases of BPH.Results　The procedure has been successful and the postoperative course uneventful in all the patients.No patient experienced TUR syndrome.All the patients got normal micturation after the urethral catheter being drawn 3～5 days later.The patients have been followed up for 1/2 to 2 years.IPSS decreased from 28.8±2.0 to 7.2±0.3 and MFR increased from (5.1±0.4) ml/s to (16.7±1.8) ml/s.Conclusions　The procedure has the advantages of both TUEVAP and TURP and is safe with low complication.It is believed to be the ideal choice for treating BPH.