经尿道前列腺切除术后性功能障碍

目的 探讨TURP对性功能的影响。方法 选取术前有正常性生活的TURP患者300例，平均年龄69岁。采取谈话方式了解其术后6个月时性功能的情况。结果 术后ED发生率为11％，逆行射精发生率为82％。结论 TURP可以造成性功能的损害。术前应告知患者这一可能的并发症。     

经尿道钬激光前列腺剜除术治疗BPH的Meta分析

目的:用Meta分析的方法评价经尿道钬激光前列腺剜除术(HoLEP)和经尿道前列腺电切术(TURP)/开放手术(OP)治疗良性前列腺增生(BPH)所致膀胱出口梗阻(BOO)的疗效和安全性. 方法:计算机检索Medline、Cochrane临床对照试验中心数据库、Embase、万方数据库和中国生物医学文献数据库,手工检索...     

中国人耻骨上前列腺摘除术与经尿道前列腺电切术对勃起功能及逆行射精影响的Meta分析

目的:利用Meta分析比较中国人耻骨上前列腺摘除术(SPPC)与经尿道前列腺电切术(TURP)对勃起功能及逆行射精影响。方法:利用MEDLINE、中国期刊全文数据库检索2009年1月以前TURP与SPPC对勃起功能影响的比较的病例对照研究。根据纳入和排除标准,筛选合适文献。应用Revman4.2软件,对纳入的文献进行Meta分析,并进行发表偏倚评估和敏感性分析。结果:8篇文献纳入本项研究,累计病例SPPC组515例,TURP组462例。SPPC组与TURP组相比发生勃起功能障碍(ED)的危险性较高,但差异无统计学意义(P>0.05),其中合并OR(95%CI)值为1.34(0.97,1.85)。SPPC组逆行射精发生率较TURP组少(P<0.05),合并OR(95%CI)值为0.58(0.44,0.76)。结论:SPPC与TURP相比,术后ED发生率差异不显著,TURP后发生逆行射精的可能性高于SPPC。     

钬激光前列腺剜除术和经尿道前列腺电切术治疗良性前列腺增生疗效和安全性的Meta分析

目的:系统评价钬激光前列腺剜除术(HoLEP)和经尿道前列腺电切术(TURP)治疗良性前列腺增生(BPH)的疗效和安全性.方法:计算机检索PubMed、Embase、The Cochrane Library和Web of Science收集比较HoLEP和TURP治疗BPH的随机对照试验(RCT),检索时限均从建库至2...     

经尿道前列腺钬激光剜除术治疗良性前列腺增生效果分析

目的 探讨经尿道前列腺钬激光剜除术(HoLEP)治疗良性前列腺增生(BPH)的安全性和临床效果.方法 回顾性分析周口永兴医院泌尿外科于2020-01—2021-04收治的84例BPH患者的临床资料.分为HoLEP组(43例)和经尿道等离子前列腺切除术组(PKRP组,41例).比较2组术中情况和术后临床指标,统计并发症发...     

SPP、TURP、HoLEP三种前列腺切除术对性功能的影响

目的比较钬激光前列腺切除术（HoLEP）、经尿道前列腺电切术（TURP）和耻骨上前列腺切除术（SPP）三种手术方式对BPH患者性功能的影响。方法随访92例前列腺切除手术的BPH患者，评价：IPSS、性生活情况、勃起功能（阴茎勃起硬度、IIEF-5）和射精情况（射精有无、精液量、有无逆行射精、有无射精痛）。结果（1）三组术后3月IPSS评分均有显著下降（P〈0．01）；（2）三组术后IIEF-5均有不同程度降低，SPP组与术前比较，差异有显著统计学意义（P〈0．01）。校正可能影响IIEF-5的因素后，三组手术IIEF．5评分改变无统计学差异；（3）HoLEP组、TURP组、SPP组勃起功能下降的发生率分别为：38．1％、28．6％、31．0％，HoLEP、SPP组术后勃起硬度下降明显；（4）HoLEP组和SPP组术后逆行射精发生率较术前有显著差异；（5）三种手术对性欲以及射精量的影响均较小；（6）勃起硬度的降低以及逆行射精的发生三种手术间无明显差异。结论HoLEP术后可导致性功能下降，主要表现在勃起功能降低和逆行射精。HoLEP术对性功能的影响与TURP和SPP相似。     

经尿道选择性绿激光汽化术与经尿道前列腺电切术治疗良性前列腺增生的Meta分析

目的:对比经尿道选择性绿激光前列腺汽化术(photoselective vaporization of prostate,PVP)与经尿道前列腺电切术(transurethral resection of prostate,TURP)治疗良性前列腺增生症(benign prostate hyperplasia,BPH)的安全性及有效性。方法:按Cochrane系统评价方法,计算机检索Cochrane library、Medline、Embase、CNKI、CBM、万方、维普等文献资料库;手工检索中文泌尿外科期刊的相关文献。收集对比PVP及TURP治疗BPH的随机对照试验,质量评价后采用RevMan 5.0软件进行Meta分析。结果:共纳入5个符合要求的RCT研究,共528例患者。Meta分析结果显示:(1)有效性方面:PVP及TURP治疗BPH,术后6个月国际前列腺症状评分、生活质量、最大尿流率和残余尿量指标差异均无统计学意义(P>0.05)。(2)安全性方面:与TURP相比,PVP手术时间较长[MD=28.97,95%CI(9.72,48.21)],术后留置导尿时间短[MD=-2.86,95%CI(-4.58,-1.13)],住院时间较短[MD=-2.32,95%CI(-2.79,-1.85)],术中输血较少[OR=0.08,95%CI(0.02,0.34)],术后尿道狭窄率无显著差异[OR=0.74,95%CI(0.27,2.07)]。结论:PVP与TURP均能显著改善轻、中度前列腺增生患者的症状,具有相似的临床疗效。与TURP相比,PVP操作更安全,术后留置导尿时间及住院时间更短;术后尿道狭窄发生率方面两种术式无显著差异。     

经尿道前列腺钬激光剜除术与经尿道前列腺电切术治疗良性前列腺增生的疗效比较

目的 探讨经尿道前列腺钬激光剜除术(homium laser enucleation of the prostate,HOLEP)和经尿道前列腺电切术(transurethrue resection of prostate,TURP)治疗良性前列腺增生(benign prostatic hyperplasia,BPH)...     

三种经尿道前列腺切除术的比较研究

目的 探讨三种经尿道前列腺切除术的优缺点。方法 回顾性分析经尿道前列腺电切术(TtmP)400例、经尿道前列腺汽化术(TUVP)20例、经尿道前列腺汽化电切术(TVRP)400例的临床资料。结果 3种手术方法的适应证、禁忌证基本相同。并发症略有差异：术后出血TURP12例(3％)，TUVP2例(10％)，TUVRP10例(2．5％)；冲洗液外渗TURP8例(2．0％)，TUVP1例(5％)，TUVRP6例(1．5％)；迟发性出血TURP10例(2．5％)，TUVP2例(10％)，TUVRP6例(1．5％)；尿道狭窄TURP6例(1．5％)，TUVP 1例(5％)，TUVRP2例(0．5％)。结论 TURP和TUVRP的适应证宽，并发症少，安全性高，疗效确切；比TUVP更具临床实用价值。     

经尿道前列腺汽化电切术对勃起功能的影响

目的 探讨经尿道前列腺汽化电切术（TUVP）对勃起功能的影响。方法 调查随访586例TUVP术患者。按年龄、术前勃起功能情况、术前术后前列腺症状评分（IPSS）、前列腺切除重量、术中是否有前列腺包膜穿孔、术中是否发生经尿道电切综合征（TURS）、术前是否进行心理疏导7个因素，分别比较其影响下的勃起功能变化情况。结果 术中前列腺切除重量、术中是否发生TURS对术后勃起功能障碍的发生无明显影响（P〉0．05）；患者年龄〉70岁、术前有勃起功能障碍、术中有前列腺包膜穿孔、手术前后IPSS分值差〈10分及术前未进行心理疏导与术后勃起功能障碍的发生有明显的关系（P〈0．05）。结论 年龄、术前性功能状况、术中是否有前列腺包膜穿孔、术前术后排尿情况变化及是否进行心理疏导这5个因素对术后勃起功能有明显影响。     

Transurethral electrovaporization vs transurethral resection for symptomatic prostatic obstruction: a meta-analysis

OBJECTIVE: To compare the effectiveness and safety of transurethral electrovaporization (TUEVP) and transurethral resection of the prostate (TURP) for symptomatic bladder outlet obstruction secondary to benign prostatic hyperplasia (BPH). METHODS: Publications comparing TUEVP and TURP were identified systematically using Medline, the Cochrane Controlled Trial Register and other database search engines. From a total of 25 randomized controlled trials, 20 studies met the predefined inclusion criteria and were subjected to a formal meta-analysis. Primary endpoints were symptom scores and peak urinary flow rates. Secondary endpoints included transfusion requirements, operative time, duration of catheterization, incidence of adverse events, hospital stay, re-operation rates and sexual dysfunction. RESULTS: After 1 year of follow-up there was no significant difference between TUEVP and TURP in urinary symptom scores and peak urinary flow rates. There was heterogeneity at baseline for both primary outcome measures. TUEVP was associated with significantly lower transfusion requirements, a shorter catheterization time, and a shorter length of stay. TURP was associated with a lower risk of urinary retention afterward and re-operation than was TUEVP. CONCLUSION: This formal meta-analysis suggests that both TUEVP and TURP in patients with symptomatic bladder outlet obstruction provide comparable improvements in maximum urinary flow rates and symptom scores. While comparative analysis is limited by the methodological shortcomings of the underlying studies and the short follow-up, both TURP and TUEVP may offer distinct advantages in terms of secondary outcomes. A future, well-designed, multicentre randomized clinical trial with extended follow-up may be needed to better define the role of vaporization techniques in treating patients with symptomatic BPH.     

经尿道钬激光前列腺剜除术与前列腺电切术近期疗效的对比分析

目的比较前列腺钬激光剜除术(holmium laser enucleation of the prostate,HoLEP)和前列腺电切术(transurethral resection of the prostate,TURP)治疗良性前列腺增生(benign prostatic hyplasia,BPH)的疗效及安全性。方法将2012年6月至2013年7月90例行腔内手术治疗的BPH患者随机分为2组,分别行前列腺钬激光剜除术(HoLEP)和经尿道前列腺电切术(TURP)。监测、记录2组患者围手术期和术后1、3、6个月复查指标,比较最大尿流率(maximum flow rate,Qmax)、国际前列腺症状评分(international prostate symptom score,IPSS)、生活质量评分(quality of life score,QOL)等变化并进行统计学分析,比较两种术式近期临床疗效。结果术前两组患者一般情况和国际前列腺症状评分、生活质量评分、最大尿流率、残余尿量测量以及前列腺重量比较差异无统计学意义(P0.05);HoLEP组较TURP组术中出血量、手术时间、低钠血症的发生率、膀胱冲洗时间、留管时间都较低(P0.01);术后1个月、3个月及6个月2组IPSS、QOL和Qmax均比术前有明显改善(P0.01);但2组间比较并无显著统计学意义(P0.05)。结论 HoLEP术与TURP术相比,近期手术效果相似,且手术安全性更好,可视为治疗BPH的较好新方法。     

经尿道等离子前列腺分离电切术和传统电切术治疗BPH的疗效比较

目的:比较经尿道等离子前列腺分离电切术和等离子刀经尿道传统电切术治疗良性前列腺增生(BPH)的临床疗效,并对分离电切术进行研究。方法:2005年9月至2010年8月,收集81例BPH患者,随机分为2组。单盲法,行经尿道等离子前列腺分离电切术40例,行等离子刀经尿道传统电切术41例;比较2组年龄、术前超声测量前列腺体积、手术中切除腺体重量、手术时间、术中出血、术后带尿管时间、术前及术后IPSS评分(国际前列腺症状评分)。结果:两组病例仅术后IPSS评分比较有统计学意义(P<0.05),分离电切组与传统电切组IPSS评分分别为(8.70±1.13)分和(9.95±1.54)分。结论:经尿道等离子前列腺分离电切术和等离子刀经尿道传统电切术比较,经尿道等离子前列腺分离电切术临床疗效更为显著。     

Impact on sexual function of plasma button transurethral vapour enucleation versus plasmakinetic resection of the large prostate >90 ml: Results of a prospective,randomized trial

To compare the impact of plasma button transurethral vapour enucleation of the prostate (PVEP) and plasmakinetic resection of the prostate (PKRP) on lower urinary tract symptoms and sexual function in patients with benign prostatic enlargement (BPE) >90 ml. Between July 2017 and August 2018, 101 patients with symptomatic BPE were randomly, prospectively assigned to either PKRP or PVEP in our department. The clinical characteristics and sexual function were evaluated before and after surgery. Post-void residual volume, IPSS and QoL were all significantly decreased compared with baseline data in each group, while Qmax was significantly increased. The IIEF-5 score showed a slight but nonsignificant increase in both groups at 3 and 6 months after surgery, and there was no significant difference between the two groups. The post-operative rate of reduced ejaculate volume was significantly higher than the pre-operative rate in PKRP group, while there was no significant difference in PVEP group. PVEP had an attenuated effect on no ejaculate compared with PRKP, and they both had a significantly negative effect on no ejaculate. PVEP is an effective and minimally invasive procedure for large prostate. Compared with PKRP, PVEP has no effect on erectile dysfunction and has a lower negative impact on ejaculation.     

Holmium laser resection of the prostate versus transurethral resection of the prostate: results of a randomized trial with 4-year minimum long-term followup

PURPOSE: It has previously been shown that holmium laser resection of the prostate (HoLRP) is superior to transurethral resection of the prostate (TURP) with regard to perioperative morbidity and is equivalent to TURP in the short term. We present the long-term results of a randomized, prospective trial comparing HoLRP to TURP since information regarding the durability of holmium prostatectomy is lacking in the literature to date. MATERIALS AND METHODS: A total of 120 patients with urodynamic obstruction were randomized (April 1996 to August 1997) into 2 comparable groups and assigned to HoLRP or TURP. All patients were assessed preoperatively and followed prospectively at 3 weeks, 3, 6, 12, 24 and 48 months postoperatively with an American Urological Association symptom score, quality of life score, peak urinary flow rate, and questionnaires concerning sexual function and continence. Preoperative pressure flow studies, ultrasound prostatic volume assessment and post-void residual volume measurement were repeated at the 6-month visit. All adverse events were noted. RESULTS: Of 120 patients 73 completed the 48-month assessment. HoLRP and TURP resulted in significant improvements in all parameters. There was no difference between the 2 techniques in terms of urodynamic parameters, potency, continence and symptom scores at the 48-month assessment. HoLRP took significantly longer to perform but perioperative morbidity, catheter time, nursing contact time and hospital stay were significantly less for HoLRP compared to TURP. CONCLUSIONS: HoLRP and TURP give equivalent and satisfactory long-term results, with no differences noted in major morbidity. This confirms the durability of these 2 treatments. Peri-operative morbidity is less with HoLRP.     

经尿道等离子体前列腺剜除术与经尿道等离子体前列腺切除术的对比研究

目的比较经尿道等离子体前列腺剜除术（PKEP）与经尿道等离子体前列腺切除（PKRP）近期疗效。方法将具有手术指征的120例前列腺增生症（BPH）患者随机分为两组,分别行PKEP和PKRP,监测、记录患者围手术期和术后6个月复查的有关指标,对所测指标进行统计学分析。结果术前两组一般情况比较,差别无显著性（P〉O．05）;术中出血量、手术时间、术后平均膀胱冲洗时间、置管时间和住院时间,PKEP组明显少于PKRP组（P〈O．05）;切除腺体重量,PKEP组（（31．6±11．5）g3明显多于PKRP组[（19．7土10．4）g3（P〈O．05）;术后6个月,两组患者残余尿量、最大尿流率均比术前得到明显改善（P〈O．05）。结论PKEP治疗BPH具有与PKRP相近的近期疗效;患者术中并发症发生率、恢复时间PKEP明显少于PKRP,是目前有望替代PKRP的一种新方法。     

经尿道电汽化加电切术治疗前列腺增生症180例临床分析

目的探讨良性前列腺增生症（BPH）的有效治疗方法。方法采用经尿道前列腺电汽化术（TUEVP）加经尿道前列腺电切术（TURP）联合治疗BPH 180例。结果180例手术成功，平均手术时间67min。1例发生TURS，2例输血，术后24～96h拔除导尿管，排尿均通畅。术后随访3～46个月，国际前列腺症状评分（IPSS）8.8分，最大尿流率（Qmax）20.2ml/s。结论TUEVP和TURP联合治疗BPH兼有两者优点，是治疗BPH的有效方法。     

他达拉非治疗经尿道前列腺切除术后勃起功能障碍疗效观察

目的:评估他达拉非在治疗经尿道前列腺切除术(TURP)后勃起功能障碍(ED)的疗效。方法:113例TURP术后的ED患者接受为期3个月的希爱力(商品名他达拉非)治疗,治疗后随访6个月。在治疗前后及随访6个月后记录各组患者IIEF-5评分及患者性生活日记中插入和保持勃起的成功率并比较研究。结果:患者IIEF-5评分治疗前为(9.83±3.96)分,治疗后为(20.23±3.25)分,随访6个月后为(17.28±3.03)分,差异均有统计学意义(P<0.05)。药物治疗后,患者性生活日记中插入和完成性交的成功率分别从治疗前的44.8%和7.5%提高至治疗后的81.7%和63.2%。结论:他达拉非可以作为治疗TURP术后ED的一线用药。