Alyaev Yu G, Pshikhachev A M, Perekalina A N
Department of Urology, I.M. Sechenov First MSMU, Research Institute of Uronephrology and Human Reproductive Health.
Urologiia. 2016 Nov(5):115-118.
The combination of bladder cancer with benign prostatic hyperplasia (BPH) occurs in 5-27% of cases. The link between these diseases has not yet been closely investigated. The main role in the pathogenesis of bladder cancer combined with BPH is played by the residual urine and prolonged exposure of urothelium to the urine carcinogens. The choice of surgical treatment modality for the combination of non-muscle invasive bladder cancer and BPH is still a matter of debate. There is no consensus on the safety and appropriateness of simultaneous transurethral resection of the bladder and prostate in these patients. On one hand, opponents of simultaneous surgery suggest sustained exposure to carcinogens and the spread of tumor cells in a transurethral resection through the prostate wound surface in the blood and lymphatic vessels. On the other hand, supporters refer to studies and meta-analyzes showing that the simultaneous resection neither increases the recurrence rate of bladder cancer nor causes metastasis and tumor progression.
膀胱癌合并良性前列腺增生(BPH)的情况在5%至27%的病例中出现。这些疾病之间的联系尚未得到深入研究。残余尿液以及尿路上皮长期暴露于尿液致癌物在膀胱癌合并BPH的发病机制中起主要作用。对于非肌层浸润性膀胱癌合并BPH患者,手术治疗方式的选择仍是一个有争议的问题。对于这些患者同时进行经尿道膀胱和前列腺切除术的安全性和适宜性尚无共识。一方面,同时手术的反对者认为,经尿道切除术中致癌物会持续暴露,肿瘤细胞会通过前列腺创面在血液和淋巴管中扩散。另一方面,支持者提及研究和荟萃分析表明,同时切除既不会增加膀胱癌的复发率,也不会导致转移和肿瘤进展。