经尿道等离子和钬激光前列腺剜除术治疗大体积前列腺增生的比较研究

目的比较经尿道等离子前列腺剜除术(PKEP)和钬(Holmium-YAG)激光前列腺剜除术(HoLEP)二种术式治疗大体积前列腺增生(≥80 mL)的安全性及有效性。方法回顾性分析2014年1月至2018年6月在我院手术治疗的大体积前列腺增生的病例,共180例,前列腺体积均大于80 mL。分经尿道等离子前列腺剜除术组(90例)和Holmium-YAG激光前列腺剜除术组(90例),对2组患者的术前、术中、术后的相关资料及术后18个月的随访资料进行比较。结果2组患者术前基线数据无统计学差异。PKEP组前列腺剜除时间、前列腺组织清除时间、总手术时间均较HoLEP组长,有统计学差异。2组出血量、切除腺体重量,无统计学差异。PKEP组住院时间长于HoLEP组,有统计学差异。2组术后短暂尿失禁、尿路感染、尿道狭窄等术后并发症,无统计学差异。在18个月的随访中,2组均有部分患者失访,所能随访到的2组患者的尿流率、PSA值、IPSS评分、QOL评分的记录比较,无统计学差异。结论HoLEP和PKEP均是治疗大体积前列腺增生的较为有效的外科干预措施。具有相似的安全性和有效性。

Bipolar plasmakinetic transurethral enucleation versus holmium laser enucleation of prostate for the treatment of large-volume prostates>80 ml

Objective Bipolar plasmakinetic transurethral enucleation versus holmium laser enucleation of prostatc for the treatment of large-volume prostates>80 mL.Methods A total of 180 cases of large-volume benign prostatic hyperplasia(BPH)treated in Central Hospital of Jin’an District from January 2014 to June 2018 were retrospectively analyzed.The volume of their prostate was more than 80 mL.The patients were randomly divided into the PKEP group(90 cases)and the Ho LEP group(90 cases).The preoperative,intraoperative and postoperative relevant data and the follow-up data of 18 months after the operation were compared between the two groups.Results There was no significant difference in preoperative baseline data between the two groups.The enucleation time,prostate tissue clearance time and total operation time of PKEP group were significantly longer than those of Ho LEP group.There was no significant difference in the amount of bleeding and the weight of resected gland between the two groups.There was no significant difference in postoperative complications such as transient urinary incontinence,urinary tract infection and urethral stricture between the two groups.During the 18-month follow-up,some patients in both groups were lost to follow-up.There was no statistical difference in urine flow rate,PSA value,IPSS score,QOL score between the two groups that could be followed up.Conclusion Both Ho LEP and PKEP are effective and durable surgical interventions for the treatment of lower urinary tract symptoms caused by the large prostatic hyperplasia.Both of them have the similar safety and effectiveness.