Transurethral vaporization and resection of the prostate for benign prostatic hyperplasia Xie Lei Deng Xiaoxiao Xiaoyong Li Wenjie Xie Chaofan Ye Qihui Xia Honghui cutting (TUVP) and prostate transfusion (TURP) treatment of 62 cases of benign prostatic hyperplasia. Results The operation time was short, no serious complications, and the effect was satisfactory. Conclusion TUVP combined with TURP is safe and effective for the treatment of benign prostatic hyperplasia.
Prostatic disease (BPH) is a common and frequently-occurring disease in older men.
Transurethral vaporization of the prostate (TUVP) has the greatest advantage of less bleeding, faster recovery, and significantly improved symptoms. We used TUVP from February 2003 to August 2005 and treated 62 cases of BPH with prostatectomy (TURP). The results were satisfactory. The report is as follows.
1 Materials and Methods 1.1 General Information This group of 62 patients, aged 57-82 years, mean 655 years; duration of 6 months to 10 years, an average of 53 years; all have severe dysuria symptoms. Among them, chronic bronchitis. 3 cases of emphysema; coronary heart disease. hypertension. 10 cases of abnormal electrocardiogram; 2 cases of diabetic patients; 2 cases of renal hydronephrosis. The International Prostatic Hyperplasia Symptom Score (IPSS) scored 20-30 points with an average of 257 points. The maximum urine flow rate is 0-12.7ml/s, the average is 7.2ml/s; the residual urine volume is 50-1000ml, and the average is 110ml. 1.2 The surgical method uses German Storz vaporization resectoscope. Vaporization cutting output power 200-300W 〖, coagulation power 80W 〖; electric cutting output power 150-160W å© rinsing liquid is 5% glucose injection. Take the lithotomy position and use spinal anesthesia plus continuous epidural anesthesia. After entering the mirror, firstly, the cystoscopy observed the morphological changes of the bladder, the relationship between the left and right ureteral orifice position and the enlarged gland, the relationship between the precise sphincter position and the external sphincter, the morphology, length and posterior lip of the prostatic hyperplasia. The electric chopped sputum is used for deep vaporization and cutting on the prostatic body. At a speed of 1 mm per second and a depth of about 3 mm, the proliferating prostate tissue is excised, and the blood is cut while cutting to ensure clear vision. The depth of resection is close to the prostate capsule. Near the prostate capsule and the tip of the prostate, use low output power, using thin slices, short-cut or reverse push, do not hurt the external urinary sphincter. Before the end of the operation, carefully observe the condition of the section, completely stop the bleeding, make the resection surface flat, and avoid the residual of the valve-like tissue. The ElKck suction pump is used to suck the cut prostate tissue out of the bladder. The 20-22F three-chamber balloon was filled with water 40-60ml. The urethral tube was removed from the 4th to the 5th day after the operation, and the self-urination was resumed.
13 statistical methods t test.
2 Results of bleeding, no case of TUR syndrome, resection of prostate tissue 14-60g, postoperative follow-up of 6-14 months, temporary urinary incontinence in 1 case, self-healing after 2 months of exercise urethral sphincter, urethral opening narrow 1 For example, it is cured by urethral dilatation. IPSS 5-15 was measured at 3 months after surgery, with an average of 7.2 points; 59 cases (95%) had no residual urine volume, 3 cases (5%) still had residual urine average 24 ml; maximum urinary flow rate was 16-22 m/s average It was 188 m/s. In this group, 12 patients underwent bladder examination 3-6 months after operation, showing that the urethra was spacious and the surface mucosa was smooth. Postoperative IPSS, maximum urinary flow rate, and residual urine volume are significantly improved compared with preoperative. 0.01) 3 Discussion Currently, transurethral resection of the prostate has become a routine procedure for the treatment of BPH. Internationally, TURP is regarded as a treatment for BPH. The gold standard, TUVP is considered a continuation of this "gold standard." The shortcoming of TURP is that it requires high operation technology, is not easy to control bleeding and is prone to water poisoning. It is difficult to remove large glandular gland, and it may cause residual TUVP to cause vaporization and dehydration effects after recurrence of gland. After vaporization, a layer of tissue-solidified layer is formed, which closes the blood vessel, and the bleeding and water absorption are less. For "blood-free TURP, the TUR syndrome is basically eliminated, it is safer, but the relative time is longer. This group combines the characteristics of TUVP and TURP to complement each other. On the basis of TUVP, the TURP is used to coagulate and cut the coagulation after vaporization. Layer resection and repair is conducive to wound healing, reducing the post-hematuria urinary tract irritation caused by necrotic tissue shedding. Combine these two methods to give full play to their respective Lei. Xiao Xiaoyong. Li Wenjie. Ye Qihui. Xia Honghui) People's Liberation Army 451 Hospital urology (Deng Xiao) Zhongshan Medical Wen X JalElElectronicPublish advantages of their respective shortcomings make color Doppler ultrasound diagnosis of coronary artery fistula during operation time. Lin Huiwu strong arterial sputum accuracy. Method summary from 1997 to 2005 8 Patients with coronary artery fistula (all confirmed by surgery) and 145 cases reported in core journals in recent years, a total of 153 cases of coronary artery fistula The characteristics of color Doppler two-dimensional echocardiography were analyzed by meta-analysis to find the hemodynamics and regularity of image features of coronary artery spasm. According to the image characteristics, color Doppler ultrasound can make correct diagnosis and diagnostic accuracy for 133 cases. 87%. Its two-dimensional and color Doppler blood flow map and spectral features are obvious, which can show the opening of the affected coronary artery. The inner diameter. Tracking which compartment is broken into the fistula, which has guiding effect on surgery and interventional therapy. Conclusion Color Doppler two-dimensional echocardiography has a definite diagnostic value for coronary artery fistula.
Coronary artery spasm is a rare congenital cardiovascular malformation, which refers to the abnormal traffic between the coronary artery and the heart chamber or large blood vessels, accounting for 0.3% of congenital cardiovascular disease. It is difficult to diagnose with clinical symptoms and signs alone. . This article summarizes 8 patients with coronary artery spasm diagnosed in our hospital from 1997 to 2005 (all confirmed by surgery) and 153 cases of 153 cases of coronary artery spasm reported in core journals in recent years. It is not difficult. None of the 62 patients in this group had TUR syndrome.
Regarding the operation of the operation, the author's experience is: (1) The neck treatment and cutting reveals the ring-shaped fiber, which is required to be flat, and should not be too deep, otherwise there will be urinary tract dysfunction or even bladder neck contracture after urethra. (2) Tip trimming, instead of high output power vaporization and electric cutting, instead use low output power cutting, near the tip of the prostate with electric cutting, no power to reverse the prostate gland away from the external urethral sphincter and then cut Minimize the cauterization of the external sphincter and avoid damage.
BPH is a disease of the elderly, and the incidence of diseases in the medical system is high, especially hypertension, coronary heart disease, chronic obstructive pulmonary disease, diabetes. These diseases seriously affect the health of patients, and the risk of surgery is large, and the bleeding during surgery is easy to induce. The onset of medical diseases, poor healing after surgery, easy to continue to send blood. Therefore, effective control of blood pressure before surgery, improve cardiac blood circulation and cardiopulmonary function; drainage of urine to restore kidney and bladder surgery perioperative serious complications.
Through the successful operation of 62 patients in this group, we believe that TUVP and TURP combined with electric resection is a safe and effective method for the treatment of BPH. The perioperative treatment of high-risk patients can also achieve a good outcome. It is not the selection criteria for endovascular treatment. With the continuous promotion of TUVP and TURP technology, it has become a more mature operation.
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