Specificities of operative treatment of patients with prostate cancer in combination with urinary bladder stones
Authors / Institutions
Yu.G.Alyaev /
Leonid M. Rapoport /
Akhmed M. Pshikhachev /
Evgeniy V. Shpot /
Роль дисбактериоза кишечника в развитии дефицита железа /
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The objective. To determine a tactics of treatment of patients with prostate cancer (PC) in combination with urinary bladder stones.Patients and methods. Of 1602 patients with prostate cancer (PC) stones of the urinary bladder (UB) were found in 22 (1.4%). Blood PSA levels were within the range 7.9–18.5 ng/ml, prostate volume was 22 to 67 cm3, maximal size of bladder stones – from 5 to 45 mm. In 8 patients, 2 and more concrements were found in the urinary bladder.
Results. One-step surgical treatment due to an UB stone and prostate cancer was performed in 20 (90.1%) patients, in the other 2 (9.9%) patients the first step was removal of an UB stone. In 10 (45.5%) patients a bladder stone was removed by the method of cystolith extraction, 8 (36.4%) patients underwent open and 4 (18.2%) patients – laparoscopic cystolith extraction. 12 (54.5%)
patients underwent open or laparoscopic radical prostatectomy (RPE) due to PC. In 3 patients after laparoscopic RPE and in 1 patient after open RPE with cystolith extraction residual stones of the urinary bladder were found in the post-operative period.
Conclusion. When planning RPE due to PC in patients with a urinary bladder stone, the most preferable method is a one-step removal of an UB stone, which permits to rule out the necessity of repeat anaesthesia and surgical intervention. Removal of bladder stones during open radical prostatectomy has no technical difficulties. Laparoscopic access and multiple bladder stones
are risk factors of finding residual stones during one-step RPE with cystolith extraction. A flexible cystoscopy through the available port during laparoscopic RPE might permit to control adequate cleaning of the bladder from stones, but determination of the effectiveness and safety of this method needs further study.
Key words: prostate cancer, laparoscopic radical prostatectomy, endovideosurgical prostatectomy, urolithiasis, kidney stone, cystolithotripsy, cystolithotomy.
For citation: Alyaev Yu.G., Rapoport L.M., Pshikhachev A.M., Shpot' E.V., Perekalina A.N. Specificities of operative treatment of patients with prostate cancer in combination with urinary bladder stones. Vopr. urol. androl. (Urology and Andrology). 2019; 7(1): 17–22. (In Russian).
DOI: 10.20953/2307-6631-2019-1-17-22
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