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首页> 外文期刊>BJU international >Simultaneous transurethral cystolithotripsy with holmium laser enucleation of the prostate: a prospective feasibility study and review of literature.
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Simultaneous transurethral cystolithotripsy with holmium laser enucleation of the prostate: a prospective feasibility study and review of literature.

机译：同时经尿道前列腺摘除术经尿道膀胱胆囊碎石术：前瞻性可行性研究和文献综述。

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OBJECTIVE: To report experience with holmium laser enucleation of the prostate (HoLEP) simultaneously with transurethral holmium laser cystolithotripsy (HLC) for managing bladder outlet obstruction (BOO) and associated vesical calculi; we also review previously reported cases of managing vesical calculi and associated BOO. PATIENTS AND METHODS: The high-powered holmium laser is a very efficient multifunctional endourological instrument that effectively fragments calculi of all compositions and is capable of haemostatic cutting of tissue, resulting in minimal bleeding after prostatic resection. A prospective study was conducted from April 2003 that included 32 men who underwent simultaneous HoLEP with transurethral HLC at our institution. Demographic, laboratory, peri-operative and follow-up data were analysed. Complications during and after surgery were identified to assess the morbidity of procedure. RESULTS: The mean (range) size of bladder calculi was 34.6 (12-70) mm and the preoperative weight of the prostate was 51.9 (11-172) g. Combined HoLEP with transurethral HLC was technically feasible in all patients, and all were stone-free after surgery. The mean operative duration was 97.7 (40-230) min, the weight of prostate tissue removed 34.6 (5-88) g, and the duration of catheterization and hospital stay 29.3 h and 34.8 h, respectively. Complications during and after surgery occurred in 12.5% and 15.6% of patients, respectively; all complication were minor and none caused any residual disability to the patient. No patient required a blood transfusion or developed clot retention. CONCLUSIONS: Managing bladder stones and BOO with simultaneous transurethral HLC and HoLEP should be considered the treatment of choice for such cases. Stones of any size and composition, and prostates of practically any size can be treated endoscopically using the holmium laser, with acceptable morbidity once the technique is mastered. The review of previous reports suggested a need for a prospective study comparing endoscopic management of BOO and associated bladder stones, with medical management of BOO and extracorporeal shock wave lithotripsy/endoscopic lithotripsy for bladder stone.
机译：目的：报告前列腺激光摘除术（HoLEP）与经尿道hol激光膀胱碎石术（HLC）同时治疗膀胱出口梗阻（BOO）和相关膀胱结石的经验;我们还回顾了先前报道的治疗膀胱结石及相关BOO的病例。患者和方法：高功率激光是一种非常有效的多功能内窥镜检查仪器，可以有效地碎裂所有成分的结石，并且能够止血切开组织，从而使前列腺切除术后的出血最少。从2003年4月开始进行了一项前瞻性研究，其中包括32名在我院同时接受HoLEP和经尿道HLC治疗的男性。人口统计，实验室，围手术期和随访数据进行了分析。确定手术期间和之后的并发症以评估手术的发病率。结果：膀胱结石的平均（范围）大小为34.6（12-70）mm，术前前列腺重量为51.9（11-172）g。在所有患者中，将HoLEP与经尿道HLC联合使用在技术上是可行的，并且所有患者术后均无结石。平均手术时间为97.7（40-230）分钟，前列腺组织的重量去除了34.6（5-88）g，导尿和住院时间分别为29.3 h和34.8 h。手术期间和术后并发症分别发生在12.5％和15.6％的患者中;所有并发症均为轻度，均未对患者造成任何残障。没有患者需要输血或出现血栓滞留。结论：同时经尿道HLC和HoLEP同时治疗膀胱结石和BOO应考虑作为此类病例的治疗选择。一旦掌握了该技术，就可以使用the激光在内窥镜下治疗任何大小和组成的结石，以及几乎任何大小的前列腺。回顾先前的报告表明，有必要进行前瞻性研究，以比较BOO和相关膀胱结石的内镜治疗与BOO和体外冲击波碎石/内镜碎石治疗膀胱结石的医学管理。

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