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目的探讨经尿道前列腺隧道式电切治疗前列腺癌近距离照射治疗术后尿潴留的适应证、手术时机及其对近距离照射治疗疗效的影响。方法 2009年2月至2013年1月间,利用经尿道前列腺隧道式电切术治疗前列腺癌近距离照射治疗术后反复尿潴留患者共8例,回顾分析其临床资料。结果 8例近距离照射治疗患者术后1.5～4.5个月,行经尿道前列腺隧道式电切,手术时间30～50min,取出粒子0～5颗。采用美国近距离治疗协会推荐分级表评估电切术后尿道症状,随访6～19个月,尿道症状0级2例,Ⅰ级6例,较术前(Ⅳ级)显著改善。前列腺特异抗原(prostate specific antigen,PSA)生化复发患者1例,加用内分泌治疗;其余患者PSA为(0.42±0.40)ng/ml,无PSA生化复发。结论前列腺癌近距离照射治疗术后反复尿潴留,早期行经尿道前列腺隧道式电切是安全有效的,且电切后对近距离照射治疗疗效无明显影响。
Objective To investigate the effect of transurethral transurethral resection of tunnel prostatectomy on the postoperative urinary retention after prostatectomy, the timing of surgery and its effect on the therapeutic effects of brachytherapy. Methods From February 2009 to January 2013, 8 cases of recurrent urinary retention were treated by transurethral resection of prostate with transurethral resection of prostate cancer. The clinical data were retrospectively analyzed. Results Eight patients were treated with brachytherapy for 1.5-4.5 months after operation. Transurethral transurethral resection of the prostate was performed. The operation time was 30-50 minutes and 0-5 particles were removed. Urethral symptoms were evaluated by the American Society of Brachytherapy Rating Scale after ureteral resection. The follow-up ranged from 6 to 19 months. There were 2 cases of grade 0 urethra and 6 cases of grade Ⅰ, which were significantly improved compared with preoperative grade Ⅳ. One patient with biochemical recurrence of prostate specific antigen (PSA) was treated with endocrine therapy. The remaining patients had PSA of (0.42 ± 0.40) ng / ml, with no PSA recurrence. Conclusions Prostate cancer after brachytherapy treatment of recurrent urinary retention, early transurethral resection of the prostate tunnel is safe and effective, and after cutting the effect of short-range radiation therapy had no significant effect.