Patel H, Peddada A V, Zimmern P E, Hernandez R, Kagan R
Department of Urology, Southern California Permanente Medical Group, Kaiser Foundation Hospital, Los Angeles, USA.
J Surg Oncol. 1997 Feb;64(2):127-9. doi: 10.1002/(sici)1096-9098(199702)64:2<127::aid-jso7>3.0.co;2-d.
It has been reported that transurethral resection of the prostate (TURP) after definitive radiation therapy for prostate cancer is associated with a significant risk of incontinence. The presumed reason for incontinence is external sphincter damage from TURP or pre-existing damage from either extension of prostate cancer or radiation therapy.
We reviewed seven recent cases of TURP for bladder outlet obstruction in patients who had undergone radiation therapy for clinical stage T(3-4)M(0)N(0) adenocarcinoma of the prostate. All seven men progressed to either chronic retention or debilitating obstructive symptoms with weak peak flows from 3.4 to 5.1 cc/s (mean 4 cc/s). Each of them subsequently underwent a limited TURP.
Voiding symptoms were reduced in all patients and peak flows were improved to 6.3 to 20 cc/s (mean 14.8 cc/s) with mean follow-up 35 m. No patient developed stress urinary incontinence postoperatively.
These results suggest that TURP can be performed successfully after radiation therapy with minimal risk of stress incontinence.
据报道，前列腺癌根治性放疗后行经尿道前列腺切除术（TURP）会有显著的尿失禁风险。尿失禁的推测原因是TURP导致的外括约肌损伤，或前列腺癌侵犯或放疗造成的既往损伤。
我们回顾了7例近期因膀胱出口梗阻而行TURP的病例，这些患者曾接受针对临床分期为T（3 - 4）M（0）N（0）的前列腺腺癌的放疗。所有7名男性均进展为慢性尿潴留或出现衰弱性梗阻症状，最大尿流率微弱，为3.4至5.1毫升/秒（平均4毫升/秒）。随后他们均接受了有限的TURP。
所有患者排尿症状均减轻，最大尿流率提高至6.3至20毫升/秒（平均14.8毫升/秒），平均随访35个月。术后无患者发生压力性尿失禁。
这些结果表明，放疗后行TURP可成功进行，压力性尿失禁风险极小。
