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[Experience in treating advanced prostate cancer with bladder outlet obstruction]
Xu-Jun Sheng1, Ying-Jian Zhu, Min Ye
1Department of Urology, Xinhua Hospital, Shanghai Second Medical University, Shanghai, P.R. China. shengxujunjj@hotmail.com
Background & Objective:
The incidence and discovery rate of prostate cancer is increased in recent years; with advanced age and multiple organs dysfunction, the advanced prostate cancer patients have poor quality of life. This study was to explore suitable treatment for these patients.
Methods:
A total of 80 advanced prostate cancer patients with bladder outlet obstruction were treated by transurethral electrovaporization of the prostate (TVP), plus castration and antiandrogen therapy. Preoperative individualized preparation was performed for each patient. International prostatic symptom score (IPSS), maximum flow rate of urine (Q(max)), prostatic-special antigen (PSA), and ultrasonography were measured before and 3 months after operation.
Results:
TVP were successful in all cases. Postoperative IPSS was significantly lower than preoperative IPSS in patients with or without urine retention (13+/-3 vs. 31+/-2, 11+/-3 vs. 31+/-2, P<0.01); postoperative Q(max) was significantly higher than preoperative Q(max) in patients with or without urine retention [(19.0+/-3.3) ml/s vs. 0, (19.4+/-2.7) ml/s vs. (8.9+/-3.4) ml/s, P<0.01]. Postoperative PSA was significantly lower than preoperative PSA [(80.4+/-133.4) mg/L vs. (0.1+/-0.4) mg/L, P<0.05]. The volume of prostate was obviously reduced.
Conclusion:
TVP plus castration and endocrine therapy is a safe and effective treatment for advanced prostate cancer patients with bladder outlet obstruction.