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研究目的:探讨早期经尿道前列腺隧道式电切治疗前列腺癌近距离照射治疗术后尿潴留的适应症及其对近距离照射治疗疗效的影响。创新要点:前列腺癌近距离照射治疗已经成为75岁以上患者的首选,前列腺癌近距离照射治疗术后尿潴留发生率为1.5%~22.0%。经尿道前列腺电切常用于药物治疗无效的反复尿潴留患者,且手术时机多在近距离照射治疗术后6个月以后。经尿道前列腺隧道式电切治疗前列腺癌近距离照射治疗术后尿潴留可在6个月内进行,患者尿道症状从IV(出现尿潴留,需要导尿)下降为0级(没有症状)或I级(轻度,中度尿频,2~3次/晚),较术前改善明显,且对近距离照射治疗疗效无明显影响。研究方法:浙江大学医学院附属邵逸夫医院2009年2月至2013年7月间所有接受前列腺癌近距离照射治疗的病例共190例,其中9例(4.7%)患者术后出现反复尿潴留,且早期行经尿道前列腺隧道式电切术治疗,回顾分析其临床资料。重要结论:前列腺癌近距离照射治疗术后反复尿潴留,在严格防护下早期行经尿道前列腺隧道式电切是安全有效的,且电切后对近距离照射治疗疗效无明显影响。
Objective: To investigate the early transurethral resection of prostate tunnel-type transurethral resection of prostate cancer patients with postoperative urinary retention indications and its effect on the efficacy of brachytherapy. Innovative points: Prostate cancer brachytherapy has become the first choice for patients over the age of 75, prostate cancer brachytherapy postoperative urinary retention was 1.5% to 22.0%. Transurethral resection of prostate often used in patients with recurrent urinary retention ineffective drug treatment, and the timing of surgery in the near-distance radiation therapy after 6 months. Transurethral resection of transurethral resection of the prostate with prostatectomy for short-term prostatectomy can be performed within 6 months. The urethral symptoms in patients with IVH (urinary retention, need for catheterization) decreased to grade 0 (no symptoms) or I (Mild, moderate urinary frequency, 2 to 3 times / night), compared with preoperative significant improvement, and no significant effect on the efficacy of brachytherapy. Methods: A total of 190 patients undergoing brachytherapy with prostate cancer from April 2009 to July 2013 at Run Run Shaw Hospital of Zhejiang University School of Medicine were recruited. Among them, 9 patients (4.7%) had recurrent urinary retention after operation, And the early transurethral resection of the prostate tunnel resection, retrospective analysis of its clinical data. Important conclusion: Prostate cancer brachytherapy after repeated urinary retention after strict protection of the early transurethral resection of the prostate tunnel is safe and effective, and after cutting the effect of short-term radiation treatment had no significant effect.