Transurethral resection of prostate in the treatment of high risky and senile patients with large volume benign prostatic hyperplasia / 中国基层医药

Objective To improve the skills and level of TURP and peri-operative period managements to the high risky senile patients with large volume benign prostatic hyperplasia.Methods The clinical data of 318 high risky and senile patients whose ages above 80ys,ASA score ＞ 2 and prostate volume ＞ 60g were analyzed retrospectively.They underwent the treatment of TURP.ResultsTotal 318 patients underwent TURP were safe.The operating time ranged from 40 to 85 minutes,averaged 58.2minutes;the volume of blood transfusion ranged from 200ml to 600ml;No serious complications happened during and after the operation.With follow up of 1 ～ 12 months,the International Prostate Symptom Scores(I-PSS) decreased 14.7 averagely,Quality of Life(QOL) decreased 3.3 averagely,Maximal flow rate( Qmax ) increased 6.4ml/s averagely,and Post-voided Residual(PVR) decreased 85.3ml averagely.Conclusion The actions including sufficient preparations and evaluations pre-operatively,the maintenance to the stability of circulatory system during the operation,guaranteeing the demands of blood exchange in the vital organs such as heart,lungs and brain,are the key points to the success.

The study on the application of wire-guided supporting catheterization in the clinical urology / 中国基层医药

ObjectiveTo improve the treatment of urethral stricture and evaluate the applicative effects of wire-guided supporting catheterization in clinical urology. MethodsDuring January 2004 and December 2005, the patients with urethral stricture were dwelled with the catheters using the traditional guideless catheterization (group A). If the dwelling failed,it will be replaced by the wire-guided supporting catheterization using the improved catheters. During January 2006 and December 2009, the patients with urethral stricture were dwelled with the improved catheters using wire-guided supporting catheterization ( group B) straightly. Compared the first-time dwelling success incidence,the incidence of catheter associated urinary tract infection and side-effect events. Then after 1 year, compared the urethral stricture recrudescence and the course of treatment. ResultsThe success incidence of first-time catheterization in group A was 48.98％ (24/49) ,and in group B was 97.94％ (95/97) ,there was significant difference between 2 groups;The incidence of catheter associated urinary tract infection in group A was 12.24％, and 8. 25％ in group B, there was significant difference between 2 groups; As for the course of treatment, group A was 46. 2w,group B was 32.7w;The urethral stricture recrudescence in group A and B were 16.33％ and 9.28％ respectively,and there was significant difference between 2 groups. ConclusionThe wire-guided supporting catheterization, which minimize the injury and simplify the operation of internal urethrotomy,could makes the improved catheter easy to induct and replace, improve the success rate of first time-catheterization and prevent the false tunnel damage and new scar expansion. It could make benefit to reduce of incidence of catheter associated urinary tract infection and urethral stricture recrudescence,but also could shorten the course of treatment significantly.