CAJ | 학술논문

目的探讨良性前列腺增生症(BPH)及其伴发疾病的同期手术治疗方法及疗效、安全性.方法对205例BPH合并膀胱结石、腹股沟疝、尿道狭窄或膀胱肿瘤的患者在行耻骨上经膀胱前列腺摘除术或经尿道前列腺等离子电切术时,同期行膀胱取石或碎石术、腹股沟疝无张力修补术、尿道内切开术、经尿道膀胱肿瘤电切术(TURBt).随访期间回顾性分析上述患者的排尿情况、并发症、并发疾病的手术后情况.结果 205例手术全部成功.所有患者住院期间无并发症,无死亡病例；随访3个月～91个月,随访期间所有患者排尿通畅.33例腹股沟疝和128例膀胱结石均无复发.16例尿道狭窄1例术中内切开失败,改为开放手术,4例术后需继续尿道扩张.28例膀胱肿瘤未见前列腺窝种植转移,7例非原位复发者再次行经尿道膀胱肿瘤电切术,术后未再复发.结论 BPH合并膀胱结石、腹股沟疝、尿道狭窄、膀胱肿瘤可一期手术治疗,安全有效；有条件者,腔内手术可作为首选.
목적 탐토량성전렬선증생증(BPH)급기반발질병적동기수술치료방법급료효、안전성.방법 대205례BPH합병방광결석、복고구산、뇨도협착혹방광종류적환자재행치골상경방광전렬선적제술혹경뇨도전렬선등리자전절술시,동기행방광취석혹쇄석술、복고구산무장력수보술、뇨도내절개술、경뇨도방광종류전절술(TURBt).수방기간회고성분석상술환자적배뇨정황、병발증、병발질병적수술후정황.결과 205례수술전부성공.소유환자주원기간무병발증,무사망병례；수방3개월～91개월,수방기간소유환자배뇨통창.33례복고구산화128례방광결석균무복발.16례뇨도협착1례술중내절개실패,개위개방수술,4례술후수계속뇨도확장.28례방광종류미견전렬선와충식전이,7례비원위복발자재차행경뇨도방광종류전절술,술후미재복발.결론 BPH합병방광결석、복고구산、뇨도협착、방광종류가일기수술치료,안전유효；유조건자,강내수술가작위수선.
Objectives To investigate the effectiveness and safety of the surgical treatment of benign prostate hyperplasia(BPH)and its concomitant diseases at the same time.Methods 205 cases with BPH and other diseases have been treated simultaneously,including suprapubic prostatectomy or transurethral resection of prostate (TURP),inguinal herniorrhaphy,transurethral urethrotomy,transurethral resection of bladder tumor(TURBt)or vesical litholapaxy.During the follow-up,all the cases' micturition,complications,concunent disease situation were analyzed retrospectively.Results The treatments were successful in all cases.None had complications and none was dead in hospitalization.During the follow-up from 3 months to 91 months,all the patients are satisfactory in micturition.There was no recurrence in 33 cases of inguinal hernia and 128 cases of vesical calculi.Of the 16 cases of urethral stricture,one failed to transurethral urethrotomy for the obvious stricture and treated with open operation,the other 4 cases needed urethral dilatation after operation regularly.Seven of the 28 cases of bladder tumor underwent a second TURBt due to the recurring tumor which was far from prostatic urethra.No one was recurrent after the second operation.Conclusions BPH patients with inguinal hernia,urethral stricture,bladder tumor or vesical calculus can be treated simultaneously,which is safe and effective.Transurethral operation is thefirst choice for these patients if only the medical conditions is permitted.