Ali Liaqat, Hassan Asiya, Orakzai Nasir, Shahzad Muhammad, Khan Ihsanullah, Tariq Kifayat
Department of Urology, Institute of Kidney Diseases HMC Peshawar, Peshawar, Pakistan.
Res Rep Urol. 2020 Nov 4;12:547-554. doi: 10.2147/RRU.S273375. eCollection 2020.
To study the effectiveness and safety of combined transurethral resection of prostate (TURP) and open vesicolithotomy in patients with benign prostatic hyperplasia and massive vesical calculi in a single session.
A descriptive study conducted at the Institute of Kidney and Diseases, Peshawar Pakistan from March 2013 till December 2019. In total, 43 patients were selected by nonprobability conventional sampling. We included patients with occluding enlarged prostate size of 30-60g and bladder stones of more than 35 mm which was not amenable to cystolitholapaxy or cystolithotripsy. Conventional TURP followed by formal vesicolithotomy was performed in all patients in a single session. All the preoperative, perioperative and postoperative data were documented on structured Proforma. The data analysis was done on SPSS.
The average age of the patients included was 65 ±7.5 years. Mean size of prostate was 45.5±6.8 g and mean stone size was 38.4±4.2 mm. The majority of patients [60.4% (=26)] presented with refractory urinary retention. On average the operation time was 66.3±5.5 minutes. The mean resected volume of prostate was 23.5±6.8g and the average hospital stay was 5.5±1.2 days. Mean trial of removal of catheter was 5±0.6 days. The trial of removal of catheter was successful in all patients. Significant improvement in maximum flow and average flow was recorded in all patients ( = 0.001). On average, the complication rate noted was 6.9% ( = 3). There was no need for blood transfusion. No mortality was recorded in the study.
The combined TURP and open vesicolithotomy in a single session is an efficacious, safe and viable treatment modality for large bladder calculi secondary to moderately enlarged prostate.
研究经尿道前列腺电切术（TURP）与开放性膀胱结石切除术同期治疗良性前列腺增生合并巨大膀胱结石患者的有效性和安全性。
2013年3月至2019年12月在巴基斯坦白沙瓦肾病研究所进行的一项描述性研究。通过非概率传统抽样共选取43例患者。纳入前列腺体积增大至30 - 60g且膀胱结石直径大于35mm、无法进行膀胱碎石术或膀胱结石粉碎术的患者。所有患者均在同期先进行传统TURP，然后行开放性膀胱结石切除术。所有术前、术中和术后数据均记录在结构化表格上。使用SPSS进行数据分析。
纳入患者的平均年龄为65±7.5岁。前列腺平均大小为45.5±6.8g，结石平均大小为38.4±4.2mm。大多数患者[60.4%（=26例）]表现为难治性尿潴留。平均手术时间为66.3±5.5分钟。前列腺平均切除体积为23.5±6.8g，平均住院时间为5.5±1.2天。平均拔管尝试时间为5±0.6天。所有患者拔管尝试均成功。所有患者的最大尿流率和平均尿流率均有显著改善（P = 0.001）。平均并发症发生率为6.9%（=3例）。无需输血。研究中未记录到死亡病例。
同期进行TURP与开放性膀胱结石切除术是治疗中度前列腺增生继发大膀胱结石的一种有效、安全且可行的治疗方式。
