Clinical Analysis Of Simultaneous Surgical Treatment Of Non-Muscle Invasive Bladder Cancer With Benign Prostatic Obstruction

1.Research background and purposeFor patients with NMIBC(non-muscle invasive bladder cancer)complicated with BPO(benign prostatic obstruction),whethe simultaneous TURBT(transurethral resection of bladder tumor)+TURP(transurethral resection prostate)compared with TURBT reduces tumor recurrence and progression.What's more,we aim to evaluate the safety of concurrent surgery.2.Information and methodsRetrospective analysis of 64 patients with non-muscle invasive bladder cancer complicated with benign prostatic obstruction in the Department of Urology,First Affiliated Hospital of Dalian Medical University from January 31,2014 to January 31,2019,including patients with TURBT+TURP Thirty-one patients were assigned to the same group;33 patients with TURBT alone were assigned to the simple group.Immediately after the operation according to the pathological results and the degree of risk,immediate perfusion or immediate + maintenance of perfusion chemotherapy or immunotherapy,periodic review of cystoscopy.Compare the two sets of results,the corresponding indicators are:1)Tumor recurrence: overall recurrence rate after surgery,recurrence rate of bladder neck or prostatic fossa,time of first recurrence,first recurrence stage and grade progression rate.2)intraoperative conditions: intraoperative time,bladder perforation or TURS(transurethral resection syndrome).Data were calculated using SPSS 22.0.The t-test was used to compare the quantitative data.The chi-square test was used to compare the qualitative data.P<0.05 was considered statistically significant.3.Result1)Postoperative tumor recurrence:(1)The overall recurrence rate of bladder cancer was 5 cases(16.1%)in the same group and 13 cases(39.4%)in the simple group.The recurrence rate was significantly lower in the cohort than in the simple group(p=0.039).(2)In the same period,the bladder neck or prostate urethra recurred in 0 cases(0.0%),and the simple group bladder neck or prostate urethra recurred in 2 cases(15.4%).There was no significant difference in the recurrence rate between the two groups(p=0.510).(3)The average time of first recurrence: 24.8 months in the same group and 15.0months in the simple group.The recurrence time of the simple group was significantly shorter than that of the contemporaneous group(p=0.021).(4)Progression of the first recurrence stage: 2 cases(40.0%)in the same group and 3cases(23.1%)in the simple group(P=0.583).(5)Progression of first recurrence and grading: 3 patients(60.0%)in the same group and 5 patients(38.5%)in the simple group(P=0.608).2)intraoperative situation(1)Comparison of intraoperative time: 69.21±15.33 min in the same group and29.98±5.39 min in the simple group,and the operation time in the same group was significantly prolonged(p=0.025).(2)Bladder perforation,TURS: None.4.Conclusion1)Compared with TURBT alone,concurrent surgery did not increase intraoperative complications,which proved its safety.2)The removal of moderate to severe benign prostate obstruction during the same period did not increase the recurrence rate of bladder neck/prostate fossa,and it could reduce the recurrence rate of NMIBC and prolong the disease-free survival,but it had no significant effect on improving the progression of tumor.