攝護腺刮除手術可適用於急性尿路阻塞的攝護腺癌病人
林志德, 侯鎮邦, 林友翔, 崔克宏, 張慧朗, 陳建綸
林口長庚醫院 外科部 泌尿科
Acute urinary retention in a man with prostate cancer still eligible for transurethral resection of prostate
Chih-Te Lin, Chen-Pang Hou, Yu-Hsiang Lin, Ke-Hung Tsui, Phei-Lang Chang,
Chien-Lun Chen
Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at
Linkou, Chang Gung University, College of Medicine, Taoyuan, Taiwan
Objective: To interrogate the outcome of transurethral resection of prostate (TURP) in men with prostate cancer (PCa).
Methods: A total of 160 patients with prostate cancer undergoing TURP for acute urinary retention (AUR) between 2001 and 2010 were retrospectively reviewed. Thirty-eight patients undergoing palliative TURP (pTURP group) and the other 122 patients with newly diagnosed prostate cancer received TURP (iTURP group) were compared. We also included 9 patients with prostate cancer undergoing palliative cystostomy without TURP (cystostomy group). The data, including preoperative characteristics, perioperative morbidities and mortality were analyzed.
Results: There were no significant differences between the 2 groups in age, initial PSA (iPSA), operative time, incontinence rate, hospital stay or Foley catheter duration. However, the prostate volume was higher in iTURP group (49.31±25.57gm) than in pTURP group (39.29±18.36 gm) (p =0.006). The mean resected weight was higher in iTURP group (14 gm) than in pTURP group (10 gm). The pTURP group was more likely to recatheterization and the Foley home rate (FHR) was higher. The re-operation rate was not significant over two groups. There was no complication such as transurethral resection (TUR) syndrome or perioperative death in either group. There was no significant difference of mortality over two groups.
Conclusion: TURP can be performed safely for relief of AUR in patients with prostate cancer, no matter if the cancer was diagnosed before or after surgery. The recatherization rate and FHR were higher in pTURP group, which may be due to the palliative intent.