TURP联合肾镜下弹道超声碎石系统在治疗BPH并发膀胱结石中的应用

目的探讨经尿道前列腺电切术（TURP）联合肾镜下弹道超声碎石系统在治疗良性前列腺增生（BPH）并发膀胱结石中的应用。方法回顾性分析该院采用TURP和瑞士EMS公司第四代弹道超声系统治疗BPH并发膀胱结石18例资料。分析其清石率、膀胱穿孔、前列腺电切综合征（TURS）、严重出血、全身感染并发症情况及术前与术后国际前列腺症状评分（IPSS）、生活质量评分（QOL）、最大尿流率（Qmax）比较。结果所有患者手术均一次成功,清石率达100%。手术中无膀胱穿孔、TURS和全身感染并发症发生,1例患者术后出现血凝块填塞膀胱。术后随访3-11个月,平均6个月,所有患者均无膀胱结石复发。IPSS、QOL、Qmax与术前比较均有显著性差异（P〈0.001）。结论 TURP联合肾镜下弹道超声碎石系统治疗BPH并发膀胱结石是一种安全有效的微创治疗方法,值得在临床上推广。

Application of TURP combined with the system of pneumatic and ultrasonic lithotripsy under nephroscope in the treatment of BPH with bladder calculi

Objective To explore the application of the transurethral resection of the prostate（TURP） combined with the system of pneumatic and ultrasonic lithotripsy under nephroscope in the treatment of benign prostatic hyperplasia（ BPH） with bladder calculi.Methods The data of 18 cases of BPH with bladder calculi were retrospectively studied based on TURP combined with the system of pneumatic and ultrasonic lithotripsy under nephroscope. The stone-free rate,bladder perforation,transurethral resection syndrome（TURS）,severe bleeding complications,systemic infection,preoperative and postoperative international prostate symptom score（IPSS）,quality of life score（QOL）,maximum urinary flow rate（Qmax） were analyzed. Results All patients were successful in only one operation,and the stone-free rate was 100%. There were no bladder perforation,TURS and systemic infection in the operation. Postoperative bladder bloody tamponade occurred in one patient. We did not find bladder calculi among all patients who were followed up for 3to 11 months,an average of 6 months. IPSS,QOL,Qmax compared with preoperative had significant differences（P〈0. 001）. Conclusions TURP combined with the system of the pneumatic and ultrasonic lithotripsy under nephroscope in the treatment of BPH with bladder calculi is safe,effective and minimally invasive,which is worth popularizing in clinic.