经尿道前列腺等离子剜除术治疗小体积前列腺增生伴前列腺结石的疗效  

Efficacy of transurethral plasma kinetic enucleation of prostate in the treatment of small volume benign prostatic hyperplasia with prostatic stones

作　　者：梁胜杰 陈长青 李思敏 龚旻 朱汝健 方恺 伊庆同 LIANG Shengjie;CHEN Changqing;LI Simin;GONG Min;ZHU Rujian;FANG Kai;YI Qingtong(Department of Urology,Shanghai Pudong Hospital,Fudan University Pudong Medical Center,Shanghai 201399,China)

机构地区：[1]上海市浦东医院,复旦大学附属浦东医院泌尿外科,上海201399

出　　处：《现代泌尿外科杂志》2022年第4期315-318,共4页Journal of Modern Urology

基　　金：复旦大学附属浦东医院尿失禁与盆底疾病多学科联合诊治中心(No.MDT2021-06);复旦大学附属浦东医院院级人才项目(No.PX202005)。

摘　　要：目的评估经尿道等离子前列腺剜除术治疗小体积前列腺增生伴前列腺结石的疗效。方法回顾性分析我院2017年04月至2019年12月收治的36例行经尿道等离子前列腺剜除术的小体积前列腺增生(前列腺体积≤30 mL)伴前列腺结石患者的临床资料。分别比较术前、术后国际前列腺症状评分(IPSS)、生活质量指数(QoL)、膀胱过度活动症状评分(OABSS)、最大尿流率(Qmax)、残余尿(PVR)、24 h排尿次数、国际勃起功能指数-5(IIEF-5)等。结果所有患者均顺利完成手术,术中将前列腺结石完整清除,术后随访12个月及以上。与术前相比,术后1、6、12个月IPSS评分、QoL评分、PVR、OABSS、24 h排尿次数等均显著下降,Qmax显著上升,差异均具有统计学意义(P<0.05);术后性功能与术前相比差异无统计学意义(P>0.05)。术后排尿通畅,下尿路症状(LUTS)改善明显。随访期内未发生膀胱颈挛缩、尿失禁等并发症;1例尿道狭窄,行尿道扩张后好转。结论经尿道前列腺等离子剜除术治疗小体积前列腺增生伴前列腺结石疗效确切,能有效改善LUTS。Objective To evaluate the efficacy of transurethral plasma kinetic enucleation of prostate(PKEP)in the treat⁃ment of small volume benign prostatic hyperplasia(BPH)with prostatic stones(PS).Methods The clinical data of 36 patients who received PKEP for small volume BPH(prostate volume≤30 mL)with PS during Apr.2017 and Dec.2019 were retrospec⁃tively analyzed.The international prostate symptom score(IPSS),quality of life(QoL)score,overactive bladder symptom score(OABSS),maximum flow rate(Qmax),post-void residual urine volume(PVR),24-hour urination frequency and 5-Internation⁃al Index of Erectile Function(IIEF-5)before and after operation were compared.Results All operations were successful.Post⁃operative follow-up lasted for at least 12 months.Compared with those before operation,the IPSS,QoL score,PVR,OABSS and 24-hour urination frequency were significantly decreased at 1 month,6 months and 12 months after surgery,while Qmax in⁃creased significantly(P<0.05).Postoperative sexual function was not significantly affected(P>0.05).Postoperative urination was unobstructed and lower urinary tract symptoms(LUTS)improved significantly.During the follow-up,no complications such as bladder neck contracture or urinary incontinence occurred.One case of urethral stricture improved after urethral dilation.Conclusion Transurethral PKEP is effective in the treatment of small volume BPH with prostatic stones,which can effective⁃ly improve LUTS.

关 键 词：经尿道前列腺等离子剜除术 前列腺增生 前列腺结石 微创 小体积前列腺增生 

分 类 号：R697.32[医药卫生—泌尿科学]