title: [Choosing treatment for patients with bladder cancer combined with prostatic hyperplasia].
abstract: OBJECTIVE
  To define treatment selection criteria for patients with bladder cancer combined with benign prostatic hyperplasia (BPH).
  
  
  METHODS
  Between 2006 and 2015, 1148 patients were treated for bladder cancer and 3368 patients for BPH. Among them, 258 (22.5%) patients had both bladder cancer and BPH. 113 (11.6%) patients had indications for surgical treatment of both diseases. In this group, 18 (13.5%) patients also had bladder stones. Only 2 (1.6%) patients had tumor invading the muscle wall, while the remaining patients had non-muscle invasive bladder cancer.
  
  
  RESULTS
  In 18% of patients the surgery was done in two stages, the first for bladder cancer and the second for BPH. The remaining 82% of patients underwent simultaneous surgery. Bladder cancer recurred in 34.4% of patients.
  
  
  CONCLUSIONS
  Comparative evaluation of the results of transurethral resection of the bladder and prostate showed a greater number of intraoperative complications in patients who underwent staged surgery. In our opinion, it may be attributed to the lack of adequate visualization and access to the tumor, located near the opening of the ureter, to the intravesical prostate growth or large median lobe of the prostate. Bladder tumors greater than 3 cm, the multiple lesions and the low tumor differentiation were associated with a higher risk of bladder cancer recurrence, but recurrence rates of simultaneous and staged surgeries were not significantly different. The treatment of patients with bladder cancer in combination with BPH and bladder stones depended on the prostate volume, the number and size of stones. To reduce the risk of complications, in cases with assumed operating time more than 2 hours, it is advisable to split the treatment into two stages with BPH surgery on the second stage.
authors.affiliation: Department of Urology, I.M. Sechenov First MSMU, Research Institute of Uronephrology and Human Reproductive Health.
authors.forename: P V
authors.initials: PV
authors.lastname: Glybochko
authors.affiliation: Department of Urology, I.M. Sechenov First MSMU, Research Institute of Uronephrology and Human Reproductive Health.
authors.forename: Yu G
authors.initials: YG
authors.lastname: Alyaev
authors.affiliation: Department of Urology, I.M. Sechenov First MSMU, Research Institute of Uronephrology and Human Reproductive Health.
authors.forename: A M
authors.initials: AM
authors.lastname: Pshikhachev
authors.affiliation: Department of Urology, I.M. Sechenov First MSMU, Research Institute of Uronephrology and Human Reproductive Health.
authors.forename: N I
authors.initials: NI
authors.lastname: Sorokin
authors.affiliation: Department of Urology, I.M. Sechenov First MSMU, Research Institute of Uronephrology and Human Reproductive Health.
authors.forename: A M
authors.initials: AM
authors.lastname: Dymov
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007669:Kidney Calculi / Q000150:complications / Q000628:therapy; D017602:Lithotripsy, Laser; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011470:Prostatic Hyperplasia / Q000150:complications / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000601:surgery*
keywords: BPH; Holmium laser enucleation; benign prostatic hyperplasia; bladder cancer; bladder stones; bladder tumor; laser cystolithotripsy; transurethral resection; urothelial cancer