Bipolar Plasma Kinetic Prostatectomy Combined with Holmium Laser Percutaneous Nephrolithotomy for Senior High Risk Patients with Benign Prostate Hyperplasia and Complicated Bladder Stone
10.3969/j.issn.1009-6604.2015.04.013
- VernacularTitle:双极等离子电切联合经皮膀胱通道钬激光碎石治疗高龄高危前列腺增生合并膀胱结石
- Author:
Xuli WU
;
Peikui ZHENG
;
Weixiong HUANG
- Publication Type:Journal Article
- Keywords:
Transurethral plasmakinetic resection of the prostate;
Holmium laser percutaneous nephrolithotomy;
Benign prostate hyperplasia;
Bladder stone
- From:
Chinese Journal of Minimally Invasive Surgery
2015;(4):332-335
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluated the role of transurethral plasmakinetic resection of the prostate ( TUPKRP ) in combination with percutaneous bladder channel lithotripsy with holmium laser in the treatment of benign prostate hyperplasia ( BPH) and bladder stone in senior patients . Methods Seventy-three patients treated during January 2009 to May 2014 were retrospectively reviewed.The patients aged 70-95 years old (mean, 85.6 years old).All of the patients were complicated with one or more diseases of the cardiovascular system .Ultrasound examinations prior to operation showed the sizes of prostates ranging 35-105 g, among which 58 cases showed middle prostatic lobe protruding into the bladder cavity .The sizes of the bladder stones ranged 1.5 -4.5 cm. Results The operations were successful in all the cases .The time of lithotripsy ranged 15-50 min (mean, 24 min), and the time of prostatectomy ranged 40 -135 min (mean, 70 min).No severe complications, such as major bleeding, transurethral resection syndrome, bladder perforation, residual stones, or severe infections, were observed.The urethral catheters were removed 3-5 days after operation, without urine leakage, dysuria, or urinary incontinence.Post-operation pathology of all the cases revealed BPH .The duration of hospitalization was 5-10 d (mean, 6 d).Three months after operation, the international prostate symptom scores were decreased from (23.5 ±5.1) points to (7.5 ±1.6) points (P<0.05), the quality of life (QOL) scores were decreased from (5.1 ± 0.5) points to (2.2 ±0.8) poins (P<0.05), the maximum flow rates (Qmax) were increased from (6.2 ±2.4) ml/s to (17.9 ± 4.2) ml/s (P<0.05), and residual urine volumes were decreased from (185.6 ±29.7) ml to (30.0 ±21.2) ml (P<0.05). Conclusion Transurethral plasmakinetic resection of the prostate in combination with percutaneous bladder channel lithotripsy with holmium laser is safe and effective for the treatment of benign prostate hyperplasia and bladder stone in senior patients .
