前列腺增生症合并膀胱结石同期腔内治疗的探讨（附48例病例）

目的探讨BPH（前列腺增生症）并膀胱结石的一期腔内治疗及体会。方法回顾性分析48例BPH并膀胱结石患者经尿道前列腺切除术（TURP）,同时行钬激光碎石的临床资料和随访结果。结果 45例（94%）患者一次处理成功,3例（6%）因手术时间长,出血多中转为开放手术。平均手术时间90min,平均术中出血100mL,术中和术后无膀胱穿孔、水中毒和危及生命的并发症发生。术后随访6个月,未见结石复发及尿失禁、尿道狭窄等并发症,国际前列腺症状评分（IPSS）、最大尿流率和残余尿量较术前均有显著改善。结论对BPH合并膀胱结石的老年患者同期行钬激光碎石术和TURP的手术是安全的,效果是满意的。

Evaluation of the Endourological Treatment of BPH with Bladder Stones at the Same Time

Objective To evaluate the endourological treatment of benign prostatic hyperplasia,BPH）with bladder stone at equal pace.Methods The clinical data of 48 cases with BPH complicated with bladder stones treated by YAG Laser Lithotripsy Combined With Transurethral Resection of Prostate were reviewed retrospectively.Results 45 cases（94%） were successfully operated with endourological treatment simultaneously.However,6 cases（6%） were stopped the endourological treatment and turn to the open operation as result of over time of operation and blood.The mean operating time was 90 minutes and the mean blood loss was 100mL.No postoperative vesical perforation,water intoxication and life threatening complications were noted.No recurrence of stones,no urethral stenosis or other complications had occurred after a median followup of 6 months.IPSS,maximal flow rate and residual urine were evidently improved after operation.Conclusion The combination of TURP and YAG laser lithotripsy is a practical,safe and effective approach for BPH complicated with bladder stone with the elderly patients.