Bosco P J, Nieh P T
Department of Urology, Lahey Clinic Medical Center, Burlington, Massachusetts 01805.
J Urol. 1991 Jan;145(1):34-6. doi: 10.1016/s0022-5347(17)38240-x.
In 5 men evaluated for symptoms of obstructive voiding flexible cystoscopy revealed large or multiple bladder calculi along with small to moderate prostatic enlargement. All patients had successful localization and fragmentation of calculi with the Dornier HM3 lithotriptor. Of these patients 4 underwent transurethral resection or incision of the prostate under the same epidural anesthesia for moderate prostatic obstruction without complication and 1 subsequently required suprapubic prostatectomy of a gland with a large middle lobe that made a transurethral operation difficult. Extracorporeal shock wave lithotripsy should be considered for the primary management of large or hard bladder calculi and it is of particular value in combination with a transurethral operation for patients with small to moderate prostatic obstruction.
在对5名有排尿梗阻症状的男性进行评估时，软性膀胱镜检查发现有大的或多发的膀胱结石以及轻至中度前列腺增生。所有患者均通过多尼尔HM3碎石机成功对结石进行了定位和粉碎。这些患者中，4例在相同的硬膜外麻醉下因中度前列腺梗阻接受了经尿道前列腺切除术或切开术，未发生并发症；1例随后因中叶巨大导致经尿道手术困难而需要耻骨上前列腺切除术。对于大的或坚硬的膀胱结石，应考虑将体外冲击波碎石术作为主要治疗方法，对于轻至中度前列腺梗阻的患者，该方法与经尿道手术联合应用具有特殊价值。
