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目的:探讨前列腺增生症(BPH)并膀胱结石的微创治疗方法和疗效。方法:采用分期治疗办法,先在局麻下经尿道采用EMS系统作气压弹道碎石,3天后再行经尿道前列腺电切(TURP)。结果:34例经尿道气压弹道碎石手术时间20～60 min,平均45 min;无膀胱黏膜损伤、膀胱穿孔、泌尿系感染。患者感轻微疼痛但可忍受。其中4例患者术后排尿恢复通畅,予以出院,其余30例行TURP,手术时间20～75 min,平均50 min,术中、术后均未输血,无TUR综合征(TURS)发生。术后持续膀胱冲洗1～2天,术后5天拔除尿管,患者排尿通畅。30例患者随访3个月～2年,术后IPSS评分为(7.5±0.5)分,最大尿流率(MFR)平均>15 ml/s。结论:TURP结合EMS系统气压弹道碎石术是BPH并膀胱结石的一种安全、有效的治疗方法。
Objective: To investigate the minimally invasive treatment and efficacy of benign prostatic hyperplasia (BPH) and bladder stones. Methods: By staged treatment, the transurethral local anesthesia was used to transurethral EMS with pneumatic lithotripsy. Transurethral resection of the prostate (TURP) was performed after 3 days. Results: 34 cases of transurethral pneumatic lithotripsy were performed for 20-60 min, with an average of 45 min; no bladder mucosal injury, bladder perforation and urinary tract infection. Slight pain but patient tolerance. Among them, 4 patients had urinary voiding recovered and were discharged. The remaining 30 patients underwent TURP. The operation time ranged from 20 to 75 minutes with an average of 50 minutes. No blood transfusion or TURS occurred during and after operation. Postoperative bladder flushing continued for 1 to 2 days, 5 days after the removal of the catheter, urinary patency. Thirty patients were followed up for 3 months to 2 years. The postoperative IPSS score was (7.5 ± 0.5) min and the mean maximum flow rate (MFR) was> 15 ml / s. Conclusion: TURP combined with EMS pneumatic lithotripsy is a safe and effective treatment for BPH and bladder stones.