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目的评价经尿道选择性光汽化(PSV)同期治疗前列腺增生和膀胱癌的可行性、疗效和安全性。方法同期经尿道PSV治疗39例前列腺增生症和膀胱癌。结果所有患者均手术成功,手术时间40～160min,术中出血量10～50ml。无一例发生膀胱穿孔、闭孔神经反射及输尿管开口损伤,术后出血极少。术后平均住院4d。术后1个月国际前列腺症状评分(IPSS)由(27.3±3.3)分下降至(12.9±2.1)分(P<0.01),最大尿流率(Qmax)由(6.73±2.55)ml/s上升至(17.55±3.88)ml/s(P<0.01)。术后未出现大出血、尿道狭窄,未出现膀胱癌前列腺窝内种植转移。1例患者于术后6个月膀胱肿瘤复发,再次行经尿道PSV,随访至今未复发。结论经尿道PSV同期治疗前列腺增生和膀胱癌安全、有效,无种植转移,住院时间短。
Objective To evaluate the feasibility, efficacy and safety of concurrent transurethral selective photocoagulation (PSV) in the treatment of benign prostatic hyperplasia and bladder cancer. Methods Simultaneous transurethral PSV treatment of 39 cases of benign prostatic hyperplasia and bladder cancer. Results All the patients were operated successfully. The operation time was 40 to 160 minutes and the intraoperative blood loss was 10 to 50ml. No case of bladder perforation, obturator nerve reflex and ureteral injury, minimal bleeding after surgery. The average postoperative hospitalization 4d. The International Prostate Symptom Score (IPSS) decreased from (27.3 ± 3.3) points to (12.9 ± 2.1) points (P <0.01) and the maximum flow rate (Qmax) increased from 6.73 ± 2.55 ml / s at 1 month after operation To (17.55 ± 3.88) ml / s (P <0.01). No postoperative hemorrhage, urethral stricture, there is no bladder transitional prostate fossa implantation. One patient recurred from the bladder tumor at 6 months after operation, and once again passed through the urethral PSV. No recurrence was observed up to now. Conclusions The simultaneous treatment of transurethral PSV with benign prostatic hyperplasia and bladder cancer is safe and effective, with no metastasis and short hospital stay.