[热疗患者经尿道前列腺电切的特点]。

Urologiia i nefrologiia Pub Date : 1998-07-01
A A Kamalov, O I Apolikhin, A V Sivkov, S D Dorofeev, Iu V Kudriavtsev
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引用次数: 0

摘要

23例60 ~ 82岁的良性前列腺增生(BPH)患者在热疗后不同时期行经尿道前列腺切除术(TUR)。在内窥镜技术的表现中,我们发现尿道和膀胱宫颈前列腺部分的宏观变化具有一定的热冲击特征(能量,功率,暴露部位)。术中前列腺组织出血也主要取决于热治疗后的时间。热疗后至少3个月出现少量出血。因此,前列腺热治疗可用于BPH的联合治疗,以减少由于随后的TUR引起的内出血和术后出血。在热疗方法中,经尿道微波热疗具有微创性和深入前列腺深部的优点,效果最好。前列腺TUR应不早于热疗后3个月进行,仅适用于因循环未受影响而术中出血风险高的患者。因此,在前列腺增生患者的泌尿学检查中纳入经直肠前列腺多普勒成像是可取的。
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[Features of transurethral electric resection of the prostate in patients undergoing thermal treatment].

23 patients with benign prostatic hyperplasia (BPH) aged 60-82 years underwent transurethral resection (TUR) of the prostate in different periods after thermal treatment which had appeared uneffective or brought complications. In the performance of the endoscopic techniques we found macroscopic changes of the prostatic parts of the urethra and bladder cervix characteristic for certain thermal impact (energy, power, site of exposure). Intraoperative bleeding of prostatic tissue was also different depending primarily on the time which had passed after the thermal treatment. Minimal bleeding occurred at least 3 months after the thermotherapy. Thus, thermal treatment of the prostate can be used in combined treatment of BPH for reducing intra- and postoperative hemorrhage due to subsequent TUR. Among the methods of thermal therapy, transurethral microwave thermotherapy is preferable as minimally invasive and deeply penetrating into the depth of the prostatic gland with maximal effect. TUR of the prostate should be performed not earlier than 3 months after thermotherapy which is indicated only for patients at high risk of intraoperative hemorrhage because of unaffected circulation. Therefore, it is desirable to include transrectal dopplerography of the prostate to urological examination of BPH patients.

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