经尿道U-100双频双脉冲激光碎石术联合等离子双极汽化前列腺电切术治疗前列腺增生症合并膀胱结石  

Lithotripsy by Using U-100 Double-frequency-double-pulse Laser Combined with Transurethral Bipolar Plasmakinetic Prostatectomy for Benign Prostatic Hyperplasia Complicated with Bladder Calculi

作　　者：李凯[1] 刘继红[2] 钟明[1] 唐顺利[1] 黄顺坛[1] 罗勇[1] 

机构地区：[1]广东医学院附属中山市陈星海医院泌尿外科,中山528415 [2]华中科技大学同济医学院附属同济医院泌尿外科,武汉430030

出　　处：《中国微创外科杂志》2010年第6期545-547,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨前列腺增生症(benign prostatic hyperplasia,BPH)合并膀胱结石的腔内治疗的方法。方法 2008年1月～2010年1月采用经尿道U-100激光碎石术联合等离子双极汽化前列腺电切术(transurethral bipolar Plasmakinetic prostatectomy,TUPKVP)治疗31例BPH合并膀胱结石。结果 31例均手术成功,碎石时间20～55min,平均31min;前列腺电切时间55～150min,平均75min。无电切综合征出现,无输血、结石残留、膀胱穿孔及死亡等并发症。术后4～6d拔管,拔管后均能排尿通畅。尿失禁3例,经抗炎、提肛、膀胱训练等1～3周治愈。术后3个月,国际前列腺症状评分(IPSS)由术前(25.3±2.0)分下降至术后(8.1±0.4)分(t=27.709,P=0.000),最大尿流率(Qmax)由术前(6.5±1.6)ml/s增加至术后(17.4±3.7)ml/s(t=-29.725,P=0.000),生活质量评分(QOL)由术前(4.2±1.3)分下降至术后(2.1±0.3)分(t=13.418,P=0.000)。结论经尿道U-100激光碎石术联合TUPKVP治疗BPH合并膀胱结石安全、疗效好、并发症少。Objective To investigate the therapeutic methods for benign prostatic hyperplasia （BPH）. Methods The clinical data of 31 patients with BPH complicated with bladder calculi, who underwent transurethral bipolar plasmakinetic prostatectomy （TUPKVP） and lithotripsy by using U-100 double-frequency-double-pulse laser in our hospital, were retrospectively analyzed.Results The operations were completed successfully in all of the cases with a mean operation time of 31 min （20-55 min） for lithotripsy, and 75 min （55-150 min）for TUPKVP. During the operation, no TUR syndrome was detected, nor was blood transfusion necessary. After the procedure, no residual calculi, bladder perforation, or death occurred. Urethral catheter was withdrawn in 4-6 days after the operation without leading to dysuria. Three patients developed temporary incontinence and was then cured in 1 to 3 weeks. Three months after the treatment, The International Prostate Symptom Score （IPSS） was found decreased from 25.3±2.0 to 8.1±0.4 （t=27.709, P=0.000）; maximum urinary flow rate （Qmax） increased from （6.5±1.6） ml/s to （17.4±3.7） ml/s （t=-29.725, P=0.000）; while score of quality of life （QOL） decreased from 4.2±1.3 to 2.1±0.3 （t=13.418, P=0.000）.Conclusion TUPKVP combined with lithotripsy by using U-100 double-frequency-double-pulse laser is safe and effective for BPH complicated with bladder calculi leading to few complications.

关 键 词：前列腺增生症 膀胱结石 经尿道等离子双极汽化前列腺电切术 U-100双频双脉冲激光 碎石术 

分 类 号：R699[医药卫生—泌尿科学]