Efficacy of transurethral needle ablation of the prostate for the treatment of benign prostatic hyperplasia

BACKGROUND: We evaluated the efficacy and safety of transurethral needle ablation (TUNA) of the prostate for treatment of symptomatic benign prostatic hyperplasia (BPH) as one institute participating in a Japanese clinical trial. METHODS: Thirty-three patients with symptomatic BPH were treated with the TUNA procedure in our institute. The international prostate symptom score (IPSS), quality of life (QOL) score, residual urine volume (RV), prostate volume (PV) and peak urinary flow rates (Qmax) were measured and complications were assessed. RESULTS: We followed and evaluated 30 of the 33 cases. At 12 months there were significant improvements in the IPSS (20.7 to 11.2, P < 0.0001), QOL score (4.9 to 2.1, P < 0.0001), RV (46.6 to 22.6 mL, P < 0.01), PV (37.8 to 30.0 mL3, P < 0.002) and Qmax (8.00 to 11.0 mL/s, P < 0.002). There were no serious complications. CONCLUSION: This trial shows that the TUNA procedure is a safe and efficacious treatment for symptomatic BPH.     

经尿道等离子双极电切治疗高龄高危前列腺增生症

目的总结经尿道等离子双极电切治疗高龄高危前列腺增生症患者的经验和观察其临床疗效。方法回顾分析我科于2015年1月~2017年6月采用经尿道等离子双极电切术,治疗60例高龄高危前列腺增生症的临床资料,记录术前患者的PSA、IPSS、QOL,统计手术时间、出血量、并发症发生率、术后住院时间等资料。结果本组60例患者均顺利完成,平均手术时间103±32.3 min,平均出血量62.6±34.4 mL,无输血,术后平均住院时间平均7.4±1.1 d。术后3月Qmax 19.8~26.3 mL/s,平均23.2±1.7 mL/s;IPSS 6~17分,平均11.6±2.5分;QOL 0~3分,平均1.26±0.78分,与术前相比差异有统计学意义,t值分别为31.1、29.5、36.6,所有P0.001。术后5例出现暂时性尿失禁,1例发生术后尿道狭窄,经对症处理情况改善后出院。平均随访15.68±7.32月,均未出现尿潴留,排尿畅。结论经尿道等离子双极电切治疗高龄高危前列腺增生症患者是安全的、有效的。     

经尿道前列腺汽化电切术治疗前列腺增生症

目的探讨经尿道前列腺汽化电切术治疗良性前列腺增生（BPH）的疗效。方法采用经尿道前列腺汽化切割并电切术（TUVP）治疗前列腺增生患者215例,年龄58～93岁,平均69-4岁,病程1个月～8年,术前IPSS评分平均为30．2分。结果所有手术均取得成功,无一例转为开放手术,平均手术时间50min,术中无输血,未出现严重的并发症。术后随访1年以上67例,其中短暂尿失禁8例,经保守治疗后均于1个月内恢复。术后IPSS评分平均8．6分;平均最大尿流率（Qmax）18．8mVs,与术前比较差异均有统计学意义。结论将电切与汽化切割相结合行经尿道前列腺切除是一种微创、安全性高且疗效确切的BPH治疗方法。     

经尿道等离子体电切加剜除术治疗BPH(附230例报告)

目的:探讨经尿道等离子体双极电切(TUPKVP)加剜除术治疗BPH的安全性和疗效.方法:回顾性分析经尿道等离子体双极电切加剜除术治疗BPH 230例临床资料.结果:手术操作45～150 min,术中平均失血(1004±20)ml.切除前列腺重量约12～90 g,平均(30±9)g.无经尿道前列腺电切综合征发生.23例(10%)术后膀胱痉挛;2例(0.8%)继发术后出血再次电凝止血.随访2～24个月,IPSS评分平均降至5分.无剩余尿.结论:经尿道等离子体前列腺电切术加剜除术具有安全性高、出血少,手术时间短、并发症少、疗效确切等优点.     

经尿道双极等离子汽化电切术治疗高危重度前列腺增生

目的探索经尿道双极等离子汽化电切术在高危、重度前列腺增生患者中的安全性及其临床疗效,总结术前准备注意事项、术中手术技巧及术中监测的临床经验。方法回顾性分析85例高危重度前列腺增生(BPH)患者行经尿道双极等离子汽化电切术(TUPVP)的临床资料,观察该手术对于高危重度BPH患者的临床疗效及手术并发症的发生情况。结果手术时间50～135min,平均58±16 min;切除腺体重量16～56 g,平均31.6±9 g;术中出血量50～400 ml,平均110±36 ml。术前中心静脉压7.5±2.5 cmH2O,术中最高中心静脉压10.5±3.4 cmH2O,术后中心静脉压7.6±2.6 cmH2O。平均随访12个月,患者国际前列腺症状评分(IPSS)由25.1±2.9分降至7.2±3.2分,残余尿量由305±35 ml降至32±8 ml,最大尿流率由8.0±3.1 ml/s升至25.7±4.2 ml/s。结论经尿道双极等离子汽化电切术治疗高危重度前列腺增生安全、有效。充分的术前准备,严格的术中、术后监护和护理以及个体化的手术方案是手术成功的关键。     

THE EFFECTS OF TRANSURETHRAL NEEDLE ABLATION AND RESECTION OF THE PROSTATE ON PRESSURE FLOW URODYNAMIC PARAMETERS: ANALYSIS OF THE UNITED STATES RANDOMIZED STUDY

PURPOSE: We evaluated the effects of transurethral needle ablation and prostate resection on pressure flow urodynamic parameters in men with benign prostatic hyperplasia (BPH), compared symptomatic and objective parameters of efficacy 6 months after initial treatment, and determined whether urodynamic assessment may predict symptomatic improvement. MATERIALS AND METHODS: We enrolled 121 patients with clinical BPH, American Urological Association symptom index of 13 or greater and maximum urinary flow of 12 ml. per second or less in a randomized study comparing transurethral needle ablation to prostate resection at 7 institutions in the United States. Patients underwent baseline and followup assessments at 6 months, including pressure flow studies. RESULTS: Patients who underwent each procedure had statistically and clinically significant improvement in symptom index, BPH impact index and quality of life score. After needle ablation and prostate resection maximum flow improved from 8.8 to 13.5 (p<0.0001) and 8.8 to 20.8 ml. per second (p<0.0001), detrusor pressure at maximum flow decreased from 78.7 to 64.5 (p = 0.036) and 75.8 to 54.9 cm. water (p<0.001), and the Abrams-Griffiths number decreased from 61.2 to 37.2 (p<0.001) and 58.3 to 10.9 (p<0.001), respectively. At 6 months the differences in transurethral needle ablation and prostate resection were significant in terms of maximum flow (p<0.001) and the Abrams-Griffiths number (p<0.001) but not detrusor pressure at maximum flow or symptom assessment tools. The presence or absence of urinary obstruction at baseline did not predict the degree of symptomatic improvement in either treatment group. CONCLUSIONS: Transurethral needle ablation and prostate resection induce statistically and clinically significant improvement in various quantitative symptom assessment questionnaires at 6 months. The parameters of free flow rates and invasive pressure flow studies also significantly improve after each treatment. However, transurethral prostate resection induces a significantly greater decrease in the parameters of obstruction. Baseline urodynamic parameters do not predict the degree of symptomatic improvement and they may not be helpful in patient selection for transurethral needle ablation.     

How do I treat and follow my TUNA patients

Transurethral needle ablation (TUNA) of the prostate is an alternative treatment for benign prostatic hyperplasia (BPH) generating temperatures around 100°C leading to necrotic lesions inside the prostate. TUNA is a minimally invasive, low morbidity associated, approach that uses radiofrequency energy. The needles are covered by teflon shields that protect the urethra from thermal injury. Since the introduction of TUNA, there has been a constant upgrading of the device to improve treatment quality. The main advantage of this therapy is the possibility of an outpatient care due to its anaesthesia-free option with a prostatic block. Catheterisation after the procedure is required in 10–40% of cases. Long-term data (5 years) on TUNA demonstrate a sustained improvement of both IPSS score and urinary flow. About a quarter of patients require further intervention at 5 years’ follow-up. The safety profile, along with the significant improvement in both objective and subjective parameters observed after TUNA, makes it an attractive approach for symptomatic BPH.     

经尿道前列腺组织内消融治疗良性前列腺增生症（附36例报告）

１９９５年２～６月，对３６例ＢＰＨ患者进行了经尿道前列腺组织内消融治疗。经随访，２９例患者在尿流率、前列腺症状（Ｉ－ＰＳＳ）及生活质量（ＱＯＬ）评分等方面均有明显改善。为ＢＰＨ患者提供了又一新的非手术治疗方法。     

经尿道等离子前列腺分区剜除术治疗高危前列腺增生症的临床分析

【摘要】〓目的〓探讨经尿道前列腺分区剜除术治疗高危前列腺增生患者的临床疗效。方法〓经尿道等离子前列腺分区剜除术治疗高危前列腺增生患者89例,对其手术前后前列腺体积、残余尿量、国际前列腺症状评分(IPSS)、生活质量评分(QoL)和最大尿流率(Qmax)等指标进行统计学分析。结果〓89例患者均顺利完成手术,术中、术后均无严重并反症发生,手术时间30~110 min,平均45±12.6 min;术中切除前列腺组织净重20~60 g,平均30.6±13.2 g;出血量50~300 mL,平均110±27 mL。平均随访3个月,患者国际前列腺症状评分(IPSS)由21.6±3.9分降至11.8±5.1分,残余尿量由120.2±27.6 mL降至20.2±12.3 mL,最大尿流率由7.1±4.4 mL/s升至14.6±5.2 mL/s,与术前比较有显著性差异(P<0.05)。结论〓经尿道等离子前列腺分区剜除术治疗高危前列腺增生安全、有效。充分的术前准备,以及个体化的手术方案是手术成功的关键。     

经尿道摩西钬激光前列腺剜除术治疗良性前列腺增生的临床研究

目的探讨经尿道摩西钬激光前列腺剜除术在良性前列腺增生(BPH)患者中的应用效果,旨在为BPH患者快速康复提供更好的手术治疗方案。方法应用前瞻性随机双盲对照研究法,选取2018年8月至2019年11月在本院住院的80例BPH患者作为研究对象,将其随机分为两组,对照组(40例)采用经尿道100 W钬激光前列腺剜除术,研究组(40例)采用经尿道摩西钬激光前列腺剜除术,手术均由同一医师完成,术式为改良钬激光前列腺剜除术(三叶十七步法);比较两组的前列腺剜除时间、术中出血量、术后3 h血清钠下降程度、术后拔除尿管时间、住院时间,统计两组患者术前、术后3个月的最大尿流率(Qmax)、残余尿量(PVR)、国际前列腺症状评分(IPSS),观察学习曲线等指标。结果研究组的前列腺剜除时间、术中出血量、术后拔除尿管时间、住院时间比较差异有统计学意义(P<0.05),两组患者手术前后的血清钠变化差异无统计学意义(P>0.05);两组术后3个月的Qmax、PVR、IPSS均较治疗前显著改善(P<0.05),但术后组间比较差异无统计学意义(P>0.05);两组患者术中均无膀胱损伤及TUR综合征患者,无输血患者,无术后尿道外口狭窄患者,术后均无严重并发症;学习曲线方面,经尿道摩西钬激光前列腺剜除术的学习曲线较短。结论经尿道摩西钬激光前列腺剜除术安全性高、风险较小、疗效良好、术后康复快,且学习曲线较短,表现出较高的临床应用价值。     

经尿道等离子双极电刀前列腺剜除术治疗良性前列腺增生

目的:探讨经尿道等离子双极电刀前列腺剜除术治疗良性前列腺增生(BPH)的临床应用。方法:选择单纯BPH有手术指征患者90例,年龄59~83岁,平均71岁,随机分为2组,I组(50例)行经尿道前列腺电切术(TURP),Ⅱ组(40例)行经尿道等离子双极电刀前列腺剜除术(PKEP)。统计每例患者术前前列腺体积、国际前列腺症状(IPSS)评分、生活质量指数(QOL)评分和最大尿流率(Qm ax),手术时间,术中术后有无并发症、输血,术后有无膀胱持续冲洗及术后2周、术后6个月IPSS、QOL评分和Qm ax。结果:I组、II组术前前列腺体积平均为58.9、58.3 g;I组、II组手术时间平均为58.8、93.0 m in;I组患者中2例出现轻度电切综合征(TURS),II组患者术中术后心电监护未发现异常;术后行膀胱持续冲洗分别有3例、1例;术后导尿管拔除后出现急迫性尿失禁分别有4例;90例患者术中、术后均无输血。术前、术后2周、术后6个月IPSS评分I组平均分别为19.7分、11.6分、5.1分,II组平均分别为18.6分、8.4分、4.9分;QOL评分I组平均分别为4.6分、3.3分、1.1分,II组平均分别为4.5分、2.7分、1.1分;Qm ax I组平均分别为6.3、13.0、18.1 m l/s,II组平均分别为6.9、14.2、19.0 m l/s。两组间的手术时间、术后2周IPSS、QOL评分,各组内术前与术后6个月IPSS、QOL评分、Qm ax的差异有统计学意义(P<0.01)。两组间术前前列腺体积、术前IPSS、QOL评分和Qm ax、术后6个月IPSS、QOL评分及术后2周、术后6个月Qm ax的差异无统计学意义(P>0.05)。结论:PKEP可安全、有效、彻底治疗BPH,可作为手术治疗BPH的一种选择。     

Fotovaporización prostática láser Greenlight HPS en régimen de cirugía mayor ambulatoria

ObjectiveTo assess the efficacy and safety of photovaporization of the prostate with Greenlight HPS laser as major outpatient surgery.Materials and methodsA prospective study was conducted of a cohort of 50 patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia who underwent photovaporization with Greenlight HPS laser (120 W) as major outpatient surgery from May 2008 to February 2009.Inclusion criteria were moderate to severe obstructive lower urinary tract symptoms (IPSS of 10 or more and flowmetry with Qmax of 10 ml/sec or less due to benign prostatic hyperplasia with prostate volume less than 80 ml.Preoperative assessment included IPSS; flowmetry; physical examination; ultrasound examination of the kidney, bladder, and prostate (retropubic and transrectal); and measurement of postvoid residue and PSA levels. Surgical data were assessed (vaporization time, operating time, joules, complications during and after surgery). Patients were followed up 1 and 3 months after surgery (PSA, flow rate, IPSS questionnaire).ResultsNo patient admission or readmission was required, and bladder catheter was successfully removed from all patients within 24 hours of surgery. Mean patient age was 66.75 years. Mean prostate volume was 44.5 ml (SD +/-21). Twenty patients (40%) had prior catheterization. Qmax and postvoid values significantly improved. Major complications at follow-up included voiding syndrome-urgency in 6 patients (12%) and mild transient hematuria in 3 patients (6%).ConclusionsPhotovaporization of the prostate with Greenlight HPS laser may be safely and successfully performed as a major outpatient surgical procedure, which undoubtedly represents a change in care, for surgical treatment of patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia.     

Is transurethral vaporization a remake of transurethral resection of the prostate?

PURPOSE: Transurethral resection of the prostate (TURP) is still the gold standard method to treat benign prostatic hyperplasia (BPH). Transurethral vaporization of the prostate (TUVP) is compared with the transurethral resection of benign prostatic hyperplasia. PATIENTS AND METHODS: Over a 10-month period, 78 patients presenting with moderate and severe symptomatic BPH were randomized into two groups. A total of 38 patients underwent TURP, and 40 men underwent TUVP. The protocol included urinary flow rate (Qmax), symptomatology evaluated by the International Prostatic Symptom Score (I-PSS), and an ultrasonographic estimate of the postvoiding residual volume (PVR). The TUVP was carried out using a regular loop with the electrical source set at 250 to 300 W in the pure cutting mode. The same technique was used in the TURP, but the electrosurgical unit was set at 50 to 80 W for cutting and 50 W for hemostasis. The mean follow-up was 17 months (range 11-23 months). RESULTS: The data showed significant improvement in the symptom score, maximum flow rate, and postvoiding residual urine volume after treatment (P<0.01) in both groups. Comparing the symptom score, there was no difference between the two techniques (P = 0.88), the same occurring with the PVR (P = 0.78). However, the Qmax was higher after TURP (P = 0.02). The amount of tissue resected showed no statistical difference between the two techniques (P>0.05). Operative time, postoperative irrigation, catheter removal, and hospital stay were better with TUVP (P = 0.001). There was a statistically significant difference (P = 0.003) when we compared the occurrence of retrograde ejaculation with TURP (32%) and TUVP (65%) The TUVP using a regular loop, in addition to the advantage of the equipment and technique already being familiar to urologists, is efficient and reduces capital expenditure. CONCLUSION: The TUVP is a remake of TURP, with higher energy offering better results.     

Clinical effects of naftopidil on nocturia associated with benign prostatic hyperplasia

We studied the efficacy of naftopidil (50 mg/day) on nocturia associated with benign prostatic hyperplasia in 35 patients (62-80 years old). The patients had BPH > 20 ml, nocturia, more than 3 times, international prostate symptom score (IPSS) > 7, quality of life score (QOL) < 1, and maximum flow rate (Qmax) < 15 ml/sec. They received naftopidil for more than 6 weeks. IPSS, QOL, Qmax, micturition volume, and side effects were analyzed. Naftopidil was effective for nocturia associated with benign prostatic hyperplasia, especially when taken at night.     

Results of holmium laser resection of the prostate for benign prostatic hyperplasia

PURPOSE: To assess the results of holmium laser resection of the prostate (HoLRP) in the treatment of benign prostatic hyperplasia. PATIENTS AND METHODS: Since October 1996, 259 patients have undergone elective HoLRP. Peak urinary flow rates (Qax), IPSS scores, and duration of catheterization and hospital stay from admission to discharge catheter free were used as outcome measures. RESULTS: There were no perioperative deaths nor cases of transurethral resection syndrome. Two patients required blood transfusion. The mean duration of catheterization was 1.6 days and the mean hospital stay 2.9 days. The mean IPSS decreased from 21.0 preoperatively to 7.0 at 1 year, whilst the Qmax increased from 10.5 mL/sec to 20.5 mL/sec. CONCLUSION: The HoLRP technique is a safe and effective treatment for benign prostatic hyperplasia, allowing resection of the prostate at the level of the capsule with minimal bleeding or fluid absorption and with results equivalent to those of standard transurethral resection.     

Transurethral prostatic tissue ablation via a single needle delivery system: initial experience with radio-frequency energy and ethanol

We report an initial clinical experience to evaluate the safety and efficacy of outpatient prostatic ablation for the treatment of symptomatic benign prostatic hyperplasia (BPH) using local anesthesia (OPAL) with radio-frequency energy and intraprostatic absolute ethanol injection (EI). Twenty-three patients were treated with OPAL and five patients were treated with EI. Pre-operative data for all patients included international prostate symptom score (IPSS), quality of life score (QL), maximum flow rate (Q(max)), and post void residual determination. Prostate specific antigen (PSA) and transrectal ultrasound prostate volume determination were also done for EI patients. Needle deployment into the prostate was carried out at the 2, 4, 8 and 10 o'clock positions for lateral lobe hyperplasia and the 6 o'clock position for middle lobe hyperplasia. IPSS, QL, Q(max) and post void residual data were collected at 1, 3, 6 and 12 months post procedure. Both procedures resulted in statistically significant reductions of IPSS and QL. Trends towards improvement were seen both for Q(max) and post void residual, with Q(max) significantly improved after OPAL. Among EI patients, the prostate volume was reduced at 6 months post treatment to 37.2+/-17.9 g from 53.0+/-19.0 g (P=0.03) preoperatively. OPAL was safe but suffered from a high re-treatment rate. EI demonstrated encouraging results with regards to safety, symptom improvement and prostate volume reduction.     

经尿道等离子前列腺逆行剥离切除术治疗良性前列腺增生症

目的探讨经尿道等离子前列腺逆行剥离切除术治疗良性前列腺增生症（benign prostatic hyperplasia,BPH）的效果。方法2005年12月～2007年12月,经尿道等离子前列腺逆行剥离切除术治疗BPH68例。术前B超测量前列腺体积30～120ml,平均75ml;残余尿量（RU）60～250ml,平均89ml;最大尿流率（Qmax）3.5～6.9ml/s,平均5.1ml/s;IPSS评分19.8～23.5分,平均21.6分。结果68例均手术成功,切除的前列腺组织30～120g,其中〉60g15例。手术时间35～85min,平均45min。术中失血50～100ml,平均60ml,无输血。无前列腺外科包膜破裂、静脉窦破裂、膀胱前列腺连续部穿孔。68例术后随访4～6个月,Qmax增至16.4～23.2ml/s（平均19.8ml/s）,RU降至0～15ml（平均5ml）,IPSS评分0～6.8分（平均4.2分）,均恢复正常。无尿失禁。结论经尿道等离子前列腺逆行剥离切除术治疗BPH具有手术彻底、出血少、尿失禁发生率低等优点,手术相对简单,易于掌握。     

A PROSPECTIVE, RANDOMIZED 1-YEAR CLINICAL TRIAL COMPARING TRANSURETHRAL NEEDLE ABLATION TO TRANSURETHRAL RESECTION OF THE PROSTATE FOR THE TREATMENT OF SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA

Purpose

We assess the 1-year efficacy and safety of transurethral needle ablation of the prostate compared to transurethral resection of the prostate for the treatment of symptomatic benign prostatic hyperplasia (BPH).

Materials and Methods

A prospective, randomized clinical trial of 121 men 50 years old or older with symptomatic BPH was performed at 7 medical centers across the United States. Of the men 65 (54%) were treated with transurethral needle ablation of the prostate and 56 (46%) underwent transurethral resection of the prostate. Mean and percentage changes from baseline and between cohorts for American Urological Association (AUA) symptom score, AUA bother score, quality of life score, peak urinary flow rate and post-void residual urine volume were measured at 1, 3, 6 and 12 months following treatment. Length of procedure, hospitalization, type of anesthesia, post-procedure catheterization, side effects and sexual function were compared.

Results

Transurethral needle ablation and resection resulted in a statistically significant improvement in AUA symptom, bother and quality of life scores, peak urinary flow rate and post-void residual. At 1-year followup, needle ablation and resection were equally effective in enhancing quality of life. Needle ablation had less effect on sexual function, with resection being associated with a greater incidence of retrograde ejaculation. Needle ablation could be performed as an outpatient procedure with local anesthesia while resection required anesthesia and hospitalization. Needle ablation was associated with markedly fewer side effects than resection.

Conclusions

Compared to transurethral resection of the prostate, transurethral needle ablation of the prostate is an efficacious, minimally invasive treatment for symptomatic BPH that is associated with few side effects.     

高龄前列腺增生患者手术的临床效果评估

【摘要】目的 探讨高龄前列腺增生患者行前列腺等离子电切术治疗的临床效果。方法 选取2012年7月至2014年8月在本院治疗的高龄前列腺增生患者78例,采用经尿道前列腺增生等离子电切术治疗,观察患者治疗前后国际前列腺症状评分（IPSS）、膀胱过度活动症状评分（OABSS）、生活质量评分（QOL）、最大尿流速率（Qmax）、残余尿量（PVR）等指标。结果 78例患者均顺利完成手术,术中无包膜穿孔、尿道括约肌以及输尿管口损伤,所有患者术后随访6个月,无尿失禁以及前列腺增长复发等情况;患者术后6个月IPSS、OABSS和QOL评分分别为（10.27±3.41）分、（3.86±1.44）分和（2.18±0.94）分,明显低于手术前的（22.18±5.18）分、（5.97±1.36）分和（5.11±0.12）分,差异比较有统计学意义（P＜0.05）;患者术后6个月Qmax为（15.24±2.84）mL/s,明显高于术前的（8.87±1.59）mL/s,差异比较有统计学意义（P＜0.05）;患者术后6个月PVR为（21.05±2.56）mL,低于术前的（105.56±32.19）mL,差异有统计学意义（P＜0.05）。结论 高龄前列腺增生患者行前列腺等离子电切术治疗有较好的临床效果,且安全可靠,值得在临床推广。     

经尿道等离子前列腺剜除联合膀胱小切口治疗重度前列腺增生

目的探讨等离子电切镜经尿道剜除前列腺,联合耻骨上膀胱小切口治疗重度前列腺增生的价值。方法应用等离子电切襻和镜鞘将增生前列腺从精阜上缘延外科包膜逆行推入膀胱,于耻骨上膀胱小切口将前列腺组织或膀胱结石取出。结果80例均顺利完成手术,剜除前列腺时间25～45min,（34.3±11.4）min;经耻骨上膀胱小切口取出腺体或膀胱结石时间15～25min,（20.4±5.8）min;术中出血量50～150ml,（80.2±16.5）ml,均未输血。术后膀胱冲洗时间14～24h,（16.5±4.8）h,拔除尿管时间3～6d,平均4.4d。无电切综合征、尿外渗、闭孔神经反射,1例出现暂时性尿失禁,未做特殊处理,1个月后症状消失。80例随访3～12个月,平均9.6月,无再出血和逆行射精等,术后1个月IPSS由术前（25.3±5.2）分降至术后（11.2±1.6）分（t=36.308,P=0.000）;Qmax从术前（6.9±3.1）ml/s提高至（16.7±2.9）ml/s（t=-18.725,P=0.000）。结论经尿道等离子前列腺剜除联合膀胱小切口治疗重度前列腺增生或合并膀胱结石的患者,具有独特的临床应用价值。