非浸润性膀胱癌合并良性前列腺增生进行同期经尿道电切术的可行性研究

目的探讨非浸润性膀胱癌合并良性前列腺增生进行同期经尿道电切术的可行性。方法选取2013年1月至2014年12月南方医科大学深圳医院诊治的92例非浸润性膀胱癌合并良性前列腺增生患者作为研究对象。根据手术方式不同,将92例患者分为研究组A(n=32)、研究组B(n=35)和对照组(n=25)。研究组A进行传统的膀胱部分切除术、耻骨上前列腺摘除术。研究组B进行同期经尿道膀胱肿瘤电切术合并前列腺汽化电切术。对照组进行同期经尿道膀胱肿瘤电切术。比较各组临床疗效,术后前列腺症状改善情况及生活质量,术后性功能、并发症及复发情况。结果研究组B与研究组A比较,具有术中出血量少,手术时间、膀胱冲洗时间、留置尿管时间、住院时间短的优势,差异具有统计学意义(P<0.01);且术后前列腺症状改善情况、患者生活质量基本一致,IPSS评分、QOL评分、PVR值、MRF值差异均无统计学意义(均P>0.05)。各组术后性功能指标无差异无统计学意义(P>0.05)。研究组B的术后并发症发生率明显低于研究组A,差异具有统计学意义(P<0.01),与对照组差异差异无统计学意义(P>0.05)。三组的复发时间差异无统计学意义(P>0.05)。结论同期经尿道进行膀胱肿瘤与前列腺电切术能够明显改善患者的前列腺症状,提高患者生活质量,安全性较高。

Feasibility study of simultaneous transurethral resection for non-muscular invasive bladder cancer with benign prostatic hyperplasia

Objective To explore the feasibility of simultaneous transurethral resection for non-muscular invasive bladder cancer with benign prostatic hyperplasia.Methods 92 patients with non-invasive bladder cancer complicated with benign prostatic hyperplasia admitted to our hospital from January 2013 to December 2014 were included in this study.According to different surgical methods,the 92 patients were divided into study group A(32 cases),study group B(35 cases)and control group(25 cases).Study group A underwent conventional partial cystectomy and suprapubic prostatectomy.Study group B underwent simultaneous transurethral resection of bladder tumors combined with prostatectomy.The control group underwent simultaneous transurethral resection of bladder tumors.The clinical efficacy,postoperative improvement of prostate symptoms and quality of life,postoperative sexual function,postoperative complications and recurrence were compared between groups.Results Compared with study group A,study group B had the advantages of less intraoperative blood loss,and shorter operative time,bladder irrigation time,indwelling catheter time and hospital stay,with statistically significant differences(P<0.01).The improvement in postoperative prostate symptoms and patients′quality of life were basically the same,and there were no statistically significant differences in IPSS score,QOL score,PVR value and MRF value(all P>0.05).There was no statistically significant difference in postoperative sexual function between groups(P>0.05).The incidence of postoperative complications in study group B was significantly lower than that in study group A(P<0.01),but there was no difference with that in control group(P>0.05).There was no significant difference in recurrence time among the three groups(P>0.05).Conclusions Concurrent transurethral resection of bladder tumor and prostate can significantly improve the prostate symptoms and life quality of patients,with higher safety.