Abstract: 【Abstract】 Objective To evaluate the therapeutic efficacy of holmium laser enucleation of prostate combined with cystotomy in the treatment of benign prostatic hyperplasia combined with cystic calculus. Methods〓Between May 2010 and June 2014, 63 patients of benign prostatic hyperplasia combined with cystic calculus treated with retrograde holmium laser enucleation of prostate and cystotomy were retrospectively reviewed..The enucleated glands were pushed into the bladder retrogradely and were taken out by cystotomy together with the cystic calculus. Results〓All the operations were successfully finished. The operation time of Holmium laser enucleation was 65±25.2 (range from 30 to 110) minutes, The operation time of cyctotomy was 13±8.7 (range from 10 to 25) minutes. No blood transfusion was needed, none of the 63 patients showed intraoperative and postoperative transurethral resection syndrome, bladder perforation, residual stones, urethral stricture or other complicat-ions. Catheters were removed in 1 to 3 days after the operation. IPSS (international prostate symptom scores) decreased from 25.4±2.3 to 8.5±2.1. Qmax increased from 7.8±3.4 to 14.2±2.6. Conclusion The retrograde holmium laser enucleation of prostate and cystotomy in the treatment of benign prostatic hyperplasia combined with cystic calculus is safe and effective.

Key words: Retrograde holmium laser enucleation of prostate, BPH, Cystotomy, Cystic calculus

摘要： 【摘要】 目的 探讨治疗高龄患者前列腺增生合并膀胱结石安全、高效的手术方法。方法 采用经尿道钬激光逆行剜除+膀胱切开取出腺体及结石治疗63例BPH并发膀胱结石患者。将剜除腺体推至膀胱后,留置导尿管后取耻骨上小切口长约2~3 cm,取出剜除之腺体及结合手指触诊和X片完整取出膀胱结石。结果〓63例手术均顺利完成,前列腺剜除时间30~110 min,平均65±25.2 min。耻骨上小切口膀胱切开取石+剜除腺体取出时间10~25 min,平均13±8.7 min。术中出血量20~50 mL,平均40±13.2 mL。无输血病例,无膀胱穿孔、电切综合征、真性尿失禁及严重感染等并发症。术后1~3天拔除导尿管,术后一周伤口拆线。术后复查X片膀胱内均无残石,清石率达100%。术前IPSS评分25.4±2.3分,术后IPSS评分8.5±2.1分。术前Qmax 7.8±3.4分,术后Qmax 14.2±2.6分。结论〓经尿道钬激光逆行剜除+膀胱切开取出腺体及结石治疗前列腺增生合并膀胱结石是一种安全、高效的手术方法。

关键词: 经尿道钬激光逆行前列腺剜除术, 良性前列腺增生, 膀胱切开术, 膀胱结石