前立腺癌排尿障害に対する経尿道的切除術の効果

Abstract

Transurethral resection (TUR) in combination with endocrine therapy was performed on 30 patients who were on initial treatment for carcinoma of the prostate and 6 patients who had previously been treated for this disease, 5 of whom were suffering from relapse after a satisfactory response to endocrine therapy. This paper reports the results viewed from potential promoting of metastasis and improvement in bladder outlet obstruction. Prior to TUR, urinary retention was present in 11 of initially treated patients (36.7%) and in three of the previously treated patients (50.0%). The average duration of postoperative indwelling catheter was 3.9 +/- 1.6 days in the initially treated group and 5.2 +/- 3.1 days in the previously treated group. Among the initially treated group, two patients with poorly differentiated adenocarcinoma advancing from Stage C to Stage D (15.4%) developed postoperative metastases which demonstrated at 14 and 42 months; the timing of their occurrence, however, was thought to preclude relating the metastases to TUR. Although metastasis occurred early in two patients among the previously treated group (33.3%), it was considered a natural disease course in relapse cases. Obstructive voiding symptoms recurred postoperatively in three patients of the initially treated group (10.0%) and three patients of the previously treated group (50.0%) during 6 months or more of follow-up periods. UR performed for carcinoma of the prostate proved to be fully safe and effective in the initially treated patients, while admitting that a considerable number of relapses seen in the previously treated patients degraded its benefit to some extent. We conclude that TUR contributed to the better quality of life in both initially and previously treated groups of patients with carcinoma of the prostate.