Mansfield J T, Stephenson R A
Division of Urology, University of Utah School of Medicine, Salt Lake City 84132, USA.
Semin Urol Oncol. 1996 Aug;14(3):174-7.
Obstructive voiding symptoms are frequent complaints in men with prostate cancer. Some men with prostate cancer require transurethral resection of the prostate (TURP) for relief of these symptoms. Two central questions have been raised regarding whether TURP may have adverse effects on morbidity and mortality in patients with prostate cancer. The first question deals with potential tumor cell dissemination at the time of TURP, resulting increased progression and mortality rates. A review of the literature suggests the risk of tumor dissemination during a TURP is small or negligible. However, patients with prostate cancer and obstructive symptoms appear to have a greater likelihood of high-stage disease at presentation. When the pathological stage is known, progression and mortality outcomes are similar in TURP and non-TURP treated patients with prostate cancer. The second question deals with the potential that TURP increases treatment-related morbidity of radiation therapy or radical prostatectomy. When TURP is required before radiation therapy, the literature suggests that delaying radiation 6 to 8 weeks from the time of the TURP will minimize incontinence and bladder neck contracture to acceptable levels. The literature also indicates that radical prostatectomy may be performed with no increased morbidity following a TURP.
排尿梗阻症状是前列腺癌男性患者常见的主诉。一些前列腺癌患者需要行经尿道前列腺切除术（TURP）来缓解这些症状。关于TURP是否会对前列腺癌患者的发病率和死亡率产生不良影响，出现了两个核心问题。第一个问题涉及TURP时潜在的肿瘤细胞播散，这会导致进展率和死亡率增加。文献综述表明，TURP期间肿瘤播散的风险很小或可忽略不计。然而，有前列腺癌和梗阻症状的患者在就诊时似乎更有可能处于高分期疾病状态。当病理分期已知时，接受TURP和未接受TURP治疗的前列腺癌患者的进展和死亡率结果相似。第二个问题涉及TURP增加放射治疗或根治性前列腺切除术相关发病率的可能性。当在放射治疗前需要进行TURP时，文献表明，从TURP时间起延迟6至8周进行放射治疗将使尿失禁和膀胱颈挛缩降至可接受水平。文献还表明，在TURP后进行根治性前列腺切除术，发病率不会增加。
