Clinical Investigation Of Simultaneous Transurethral Resection Of Bladder Tumor With Benign Prostatic Hyperplasia (BPH)

Objective:To evaluate the feasibility and effect of simultaneoustransurethral resection of bladder tumor (TURB-t) and transurethral resectionof prostate (TURP) on recurrences at the bladder neck and prostatic urethra.Methods:The clinical date from121patients with bladder tumorcomplicated with BPH in our hospital from2009-03-01to2013-03-01wereretrospectively analyzed. Among the121patients,62had simultaneouslyundergone TURB-t and TURP (group A), and the rest59had undergoneTURB-t alone (group B). The clinical indicators, clinical efficacy,complications and recurrence was compared between the two groups. Theeffects of simultaneous prostate electrocision in patients with bladdercarcinoma electrocision were comprehensively evaluated.Results:The following-up period of the patients of group A ranged fromnine to thirty-six months (mean22.5months); and group B were followed upseven to thirty-six months (mean22.75months).1The surgery of simultaneous transurethral resection of bladder tumor(TURB-t) and benign prostatic hyperplasia can significantly improve theclinical symptoms. There was significant differences (P <0.01) betweenpreoperative and postoperative comparing the mean I-PSS score and QOLscore in group A during the following-up day of6months, and there was nosignificant differences (P>0.05) in group B. Between the two groups inpreoperative I-PSS score, QOL scores was no significant difference (P>0.05).The efficacy of postoperative patients in group A was significantly better thangroup B, there was no significant difference between the two groups (P<0.01). Six cases in Group B underwent TURP for benign prostatichyperplasia during the follow-up period.2No statistically significant difference（P<0.01）were found between group A and B in terms of the mean operative time, blood loss, bladderirrigation time and catheter retention time. and there was no significantdifference between two groups (P>0.05) in hospital days.3The simultaneous TURB-t and TURP can not increase postoperativecomplications. Three cases had obturator nerve reflex, three casescomplicated by postoperative bleeding, two cases of urinary tract infection,and two cases with urethral stricture in group A; and in group B, four caseshad obturator nerve reflex, two cases complicated by postoperative bleeding,three cases of urinary tract infection, one case complicated by urethralstricture. There was no significant difference between two groups (P>0.05)in the rate of postoperative complications. There were no perforation,urinary incontinence, TURS, erectile dysfunction occurred in both groups.4During the follow-up days, seven cases recurred in group A, theaverage recurrence time was16.86±7.08months, including five cases ofsingle tumor and two cases of multiple tumor; seven cases recurred and inGroup B, the average recurrence time was18.43±8.00months, including fourcases of single tumor and three cases of multiple tumor. There was nosignificant differences between the two groups neither in average recurrencerates nor recurrent time (P>0.05). There were no bladder tumor recurrence insitu and no prostatic urethra implantation.Conclusion:1Simultaneous TURB-t and TURP can not entend the hospital days,however, can significantly increase its operation time, blood loss andpostoperative bladder irrigation time, catheter retention time.2Simultaneous TURB-t and TURP is a safe, effective, painlesstreatment without increasing the risk of complications, tumor recurrence andimplantation of prostatic fossa.