前列腺增生电切术配合同期不同碎石术治疗前列腺增生合并膀胱结石的疗效及对其症状积分、生活质量的影响

目的 探讨前列腺增生（BPH）电切术配合同期不同碎石术治疗BPH合并膀胱结石的疗效及对其症状积分、生活质量的影响。方法 以本院2015年12月至2017年6月期间收治的92例BPH合并膀胱结石患者为研究对象。根据患者给予的治疗方式将其分为两组，观察组（经尿道前列腺增生电切术联合钬激光碎石术）46例，对照组（经尿道前列腺增生电切术联合气压弹道碎石治疗）46例。观察患者手术前后前列腺症状国际评分（IPSS）、最大尿流率（Q_max）、残余尿量（RUV）、生理状态、心理状态、主观判断评分情况；统计比较两组患者术后并发症发生情况。结果术前两组患者的IPSS评分、Q_max、RUV、生理状态、心理状态、社会功能状态、主观判断评分比较差异无统计学意义（P>0.05）；术后两组患者的IPSS评分、RUV均低于术前，且观察组患者IPSS评分、RUV与对照组相比明显较低（P<0.05），Q_max、生理状态、心理状态、社会功能状态、主观判断评分与术前相比明显提高，且观察组患者较对照组明显升高，组间差异有统计学意义（P<0.05）。观察组术后并发症发生率与对照组比较，差异有统计学意义（P<0.05）。结论 前列腺增生电切术联合钬激光碎石术治疗BPH合并膀胱结石的疗效显著，术后并发症发生率较低，对患者生活质量有所提高，可推广应用。     

单纯良性前列腺增生与合并慢性前列腺炎患者临床特点分析

目的:探讨单纯良性前列腺增生(BPH)与合并慢性前列腺炎(CP)患者的临床特点及其意义。方法:回顾性分析2011年10月~2013年06月我院泌尿外科行经尿道前列腺等离子电切术(TURP)治疗BPH的患者236例,按照病理诊断分为单纯BPH(35例)和合并CP(201例)两组,采用SPSS 17.0软件进行统计学分析,比较两组患者在年龄、前列腺体积、最大尿流率(Qmax)、剩余尿量(RUV)、国际前列腺症状评分(IPSS)(术前及术后3个月)、生活质量评分(QOL)、是否发生急性尿潴留(AUR)、前列腺特异性抗原(PSA)、前列腺特异性抗原密度(PSAD)等指标上是否存在差异。结果:合并CP组患者在前列腺体积、RUV、IPSS、QOL、AUR发生率等方面指标高于单纯BPH组患者,Qmax低于单纯BPH组,差异有统计学意义。而在年龄及PSA、PSAD等方面指标差异无统计学意义。手术治疗后3个月两组IPSS评分均较术前明显降低,且合并CP组较单纯组评分高,差异均有统计学意义。结论:CP可能是BPH临床进展的重要因素之一,同时也可能是导致BPH患者下尿路症状(LUTS)的重要原因之一。     

经尿道前列腺等离子剜除术合并无张力疝修补术对前列腺增生症并发腹股沟疝的应用效果研究

目的分析经尿道前列腺双极等离子剜除术（TBPKEP）合并无张力疝修补术对前列腺增生（BPH）并发腹股沟疝的应用效果。 方法收集2017年7月至2019年5月庐江县人民医院泌尿外科就诊的BPH并发腹股沟疝患者40例。根据手术方法分为对照组和观察组，每组20例。对照组患者采用经尿道前列腺双极等离子电切术（TUPKVP）合并无张力疝修补术进行治疗；观察组患者采用TBPKEP合并无张力疝修补术进行治疗。记录2组患者手术时间、术中出血量、切除组织量、术后国际前列腺症状评分（IPSS）和生活质量指数评分（QOL）、最大尿流量（Qmax）、残余尿量（RUV）。并发症发生率以百分率（%）标示，采用χ²检验进行比较；计量单位均采用均数±标准差（ ±s）表示，组间比较和组内比较分别采用t检验和配对t检验。 结果观察组手术时间（59.35±12.19）min短于对照组（72.24±15.34）min，差异有统计学意义（t=2.942，P<0.05）；观察组术中出血量（174.22±56.14）ml均显著低于对照组（296.08±67.33）ml，切除组织量（48.25± 13.42）g显著高于对照组（29.28±10.61）g，差异有统计学意义（t=6.217、4.959，P<0.05）。术后2组IPSS和QOL评分均显著低于术前，差异有统计学意义（P<0.05）；对照组显著高于观察组，差异有统计学意义（P<0.05）。术后，2组Qmax显著升高，RUV显著降低，差异有统计学意义（P<0.05）。其中，术后观察组Qmax显著高于对照组，RUV显著低于对照组，差异有统计学意义（P<0.05）。 结论与TUPKVP合并无张力疝修补术相比，TBPKEP合并无张力疝修补术治疗BPH合并腹股沟疝能显著增大患者尿流量，降低患者残余尿量，改善患者前列腺症状及患者生活质量。     

等离子电切术与钬激光剜除术治疗体积>80ml前列腺增生的比较

目的 比较经尿道前列腺等离子双极电切术（TUPKP）与经尿道前列腺钬激光剜除术（HoLEP）治疗体积>80 ml前列腺增生（BPH）的安全性及疗效。方法 纳入佛山复星禅诚医院泌尿外科2017年1月至2021年1月收治的80例前列腺体积>80 ml的前列腺增生患者,按随机数字法将其分为TUPKP组、HoLEP组,剔除失访病例,两组顺利完成研究的分别有37例、35例,记录两组术前及术后IPSS、QOL、Qmax、RUV、手术时间、术中出血量、术后留置尿管时间、术后住院天数、并发症等。结果 两组均能一期完成手术,HoLEP组的手术时间、术后留置尿管天数、术后住院天数均明显少于TUPKP组（P<0.05）,两组术后膀胱冲洗时间差异无统计学意义（P>0.05）;HoLEP组切除的前列腺组织量多于TUPKP组（P<0.05）,但手术出血量少于后者（P<0.05）。两组术后1个月、6个月的IPSS、RUV、QOL较术前显著降低（P<0.05）,Qmax较术前明显增高（P<0.05）;TUPKP组术后1个月的IPSS及QOL改善比HoLEP组更为明显（P...     

Laser prostatectomy in patients on anticoagulant therapy or with bleeding disorders

PURPOSE: Bleeding disorders or the use of anticoagulant medication are contraindications to transurethral prostate resection in men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). Laser prostatectomy has proved to be adequate surgical therapy with less blood loss than transurethral prostate resection. MATERIALS AND METHODS: A prospective, controlled study was done in patients at high risk (HR) with LUTS suggestive of BPH. They were treated with contact laser prostatectomy (CLP) or the combination of CLP with visual laser ablation prostatectomy (VLAP). HR was defined as bleeding disorders or anticoagulants use. As a control, men at normal risk with LUTS suggestive of BPH were treated with CLP. Patients completed validated questionnaires and underwent urodynamics at baseline and 6 months postoperatively. RESULTS: A total of 75 patients were included, namely 19 in the HR-CLP group, 11 in the HR-CLP-VLAP group and 45 in the normal risk CLP group. Obstruction relief, and symptomatic and subjective improvement were equal in all 3 groups. Effective capacity (maximum cystometric capacity minus post-void residual volume) also improved significantly in all except the HR-CLP group. Maximum urine flow improved in all groups but not significantly in the HR-CLP group. Intraoperative and postoperative complications were slightly higher in HR cases. However, blood transfusion was never necessary and there was no mortality. CONCLUSIONS: CLP and especially CLP-VLAP perform almost as well in HR cases compared with CLP in those at normal risk. These procedures are safe for men at HR with LUTS suggestive of BPH.     

前列腺体积与良性前列腺增生老年患者糖尿病之间的关系研究

目的 探讨前列腺体积(PV)与良性前列腺增生(BPH)老年患者糖尿病(DM)之间的关系.方法 选取2012年4月至2015年6月于本院诊断为良性前列腺增生老年(年龄≥60岁)患者115例为本研究试验对象.记录其血清甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹胰岛素(FINS)、糖化血红蛋白(HbAlc)、空腹血糖(FBG)及前列腺特异性抗原(PSA)等生化指标.结果 BPH合并DM组患者与BPH组相比PV更大[(51.5±19.1)和(41.2±10.1 mL)],PSA水平[(3.2±1.1)和(1.9±0.6 ng/mL)]及IP-SS分数更高[(12.5±1.3)和(8.9±1.1)],且组间差异具有显著统计学意义(P＜0.05).与正常FBG组相比,异常FBG组患者的PV、PSA水平均显著增加(P＜0.05).异常HbAlc组患者的PV也明显增加.另外,FINS组和IR组的PV及下尿路症状(LUTS)持续时间均分别高于正常FINS组和胰岛素敏感组.逻辑回归分析显示FBG和FINS是BPH的危险因素.结论 糖尿病与前列腺体积之间具有显著相关性,可影响良性前列腺增生的发生发展.     

良性前列腺增生症与勃起功能障碍的相关性研究

目的 研究中老年男性的下尿路症状(LUTS)与良性前列腺增生(BPH)及勃起功能障碍(ED)的相关性.方法 收集2006年1月至2008年2月在我院治疗的良性前列腺增生患者86例.对所有病例进行病史采集并进行统计学分析.结果 86例患者的ED患病率为68.60%.三个年龄组中ED的患病牢随着年龄的增加而升高.ED患病率随着LUTS程度的加重而逐渐升高.IPSS评分和残余尿量相关性良好(r=0.818,P<0.001);年龄和IIEF-5评分之间相关性良好(r=-0.688,P<0.001);IPSS评分和IIEF-5评分之间相关性良好(r=-0.686,P<0.001).控制年龄后进行统计分析,发现IPSS评分和IIEF-5评分之间仍然有相关性(r=-0.428,P<0.001).结论 前列腺体积和IPSS评分之间有弱相关性.残余尿量和IPSS评分之间相关性良好,说明残余尿量可以作为评价LUTS严重程度的一个重要指标.年龄、IPSS评分和IIEF-5评分的相关性良好,说明年龄和LUTS是ED的影响因素,其中LUTS是BPH引起ED的独立危险因素.     

PKRP与TURP治疗良性前列腺增生症的疗效比较

目的观察经尿道前列腺等离子切除术（PKRP）治疗良性前列腺增生症（BPH）的疗效及并发症,并与经尿道前列腺电切术（TURP）进行比较。方法回顾分析采用PKRP、TURP治疗的768例BPH患者,分别收集两组患者年龄、国际前列腺症状评分（IPSS）、剩余尿量（RUV）、最大尿流率（Qmax）、生活质量评分（QOL）、手术时间、术中出血量、术后尿管留置时间、住院天数、术后并发症发生率资料并进行统计分析。结果两组病例年龄、前列腺重量及术前IPSS、RUV、Qmax和QOL比较差异均无统计学意义（P〉0.05）。两组在手术成功率、平均住院时间、术后平均留置尿管时间、术中出血量和冲洗时间方面无统计学差异（P〉0.05）;两组在手术时间、并发症发生率方面有统计学差异（P〈0.05）。结论PKRP治疗BPH的近期临床疗效与TURP相当,临床上可根据患者情况和适应证选择不同方法,以获得更好的临床疗效。     

Prostate volume correlates with diabetes in elderly benign prostatic hyperplasia patients

Background

To evaluate the relationship between prostate volume (PV) and diabetes mellitus (DM) in geriatric benign prostatic hyperplasia (BPH) patients.

Methods

One hundred and seventeen geriatric patients with BPH were retrospectively studied between 2008 and 2009. Patients were divided into two groups: BPH and BPH with DM group. The effects of indexes of DM, including fasting blood glucose (FBG), 2-h postprandial blood glucose, glycosylated hemoglobin (HbA1c), fasting insulin (FINS), insulin resistance (IR) index, prostate-specific antigen (PSA), International Prostate Symptom Score (IPSS), and lower urinary tract symptoms (LUTS) were evaluated.

Results

The values of PV (P = 0.005), PSA (P = 0.013), and IPSS (P = 0.01) in the BPH patients with DM group were significantly higher than in the BPH group. The values of PV (P = 0.002) and PSA (P = 0.006) in the BPH patients with elevated FBG were significantly higher than in the BPH patients with normal FBG. BPH patients with elevated HbA1c had significantly higher PV than BPH patients with normal HbA1c (P = 0.046). BPH with hyperinsulinemia group showed significantly higher PV (P = 0.017) and longer duration of LUTS (P = 0.031) than BPH patients with normal FINS. Similarly, BPH patients with IR had higher PV (P = 0.004) and longer duration of LUTS (P = 0.036) than BPH patients without IR. The logistic regression analysis showed that FBG and FINS were the risk factors for BPH.

Conclusions

Our study demonstrates that PV is closely correlated with diabetes and diabetes has a direct effect on the occurrence and development of BPH.     

良性前列腺增生患者逼尿肌功能的评估和治疗对策

目的　为了解良性前列腺增生（BPH）患者产生下尿路症状的成因,为正确诊治下尿路症状提供准确的证据。　方法　采用尿动力学方法分析无神经系统疾病的良性前列腺增生患者的膀胱尿道功能。　结果　164例良性前列腺增生患者,平均年龄67±7.04岁,膀胱出口梗阻者占61.6％（101/164）,无梗阻者占38.4％（63/164）;逼尿肌收缩力正常者为83%（136/164）,逼尿肌收缩力减弱者17％（28/164）,以上各组之间I-PSS评分和年龄无显著性差异。膀胱出口无梗阻者中逼尿肌收缩力减弱者占44.4%（28/63）,逼尿肌收缩力正常占55.6％（35/63）。在膀胱出口无梗阻者中,逼尿肌收缩力减弱合并不稳定膀胱患者为28.6％（8/28）,而逼尿肌收缩力正常合并不稳定膀胱患者57.1％（20/35）,膀胱出口无梗阻逼尿肌收缩力减弱合并不稳定膀胱患者明显少于膀胱出口无梗阻逼尿肌收缩力正常者（P＜0.02）,两组患者I-PSS评分和膀胱顺应性均无明显差异。　结论　BPH患者下尿路症状的产生不仅与前列腺增生引起的膀胱出口梗阻有关,部分患者并不存在膀胱出口梗阻,其下尿路症状的成因为逼尿肌功能变化所致,尿动力学检查能为下尿路症状患者的诊治提供可靠的依据。     

“四步法”保留膀胱颈等离子前列腺剜除术治疗前列腺增生的临床观察

目的观察"四步法"保留膀胱颈等离子前列腺剜除术治疗前列腺增生(BPH)的效果。方法采用历史对照研究,将我院2017年1月至2017年10月采用"四步法"保留膀胱颈等离子前列腺剜除术治疗的86例BPH患者设为观察组,2016年3月至2016年12月83例采用经尿道双极等离子前列腺切除术的BPH患者设为对照组,比较两组手术相关指标,患者术后均随访6个月,评价两组症状改善情况,记录术后尿道狭窄、尿失禁等并发症发生率。结果观察组腺体切除率为(74.63±10.92)%,明显大于对照组的(60.08±12.49)%(P<0.05)。观察组与对照组术后残余尿分别为(18.43±2.19)ml、(19.27±2.65)ml,国际前列腺症状评分分别为(7.18±0.39)分、(7.56±0.42)分,均明显低于术前(P<0.05)。观察组术后6个月最大尿流率为(19.63±2.71)ml/s,明显大于术前的(7.51±0.93)ml/s,且大于对照组的(18.17±2.46)ml/s(P<0.05)。观察组术中并发症发生率为2.33%,术后并发症发生率为24.42%,均低于对照组的12.05%、53.01%(P<0.05)。结论 "四步法"保留膀胱颈等离子前列腺剜除术可切除更多的增生腺体,并发症发生率低,是治疗BPH安全、有效的方法。     

A comparative study assessing clinical effects of naftopidil and tamsulosin hydrochloride on benign prostatic hyperplasia with overactive bladder

PURPOSE: We compared the efficacy of naftopidil with that of tamsulosin hydrochloride for 154 symptomatic benign prostatic hyperplasia (BPH) patients who also suffered from overactive bladder (OAB) symptoms. MATERIALS AND METHODS: Naftopidil and tamsulosin hydrochloride were administered for eight weeks. The international prostate symptom score (IPSS), QOL index, maximum flow rate (Q(max)), residual urine volume (RUV) and side effect profile were determined before the administration and after eight weeks of treatment. RESULTS: In the naftopidil group, seven parameters of IPSS and QOL index were improved significantly at the endpoint compared to the baseline. In the tamsulosin group, all parameters except frequency and straining were also improved. Both drugs improved the Q(max) at the endpoint, too. The RUV did not change in both groups. Naftopidil was also superior to tamsulosin hydrochloride regarding general treatment outcome by the Japanese clinical guideline of urinary disturbance. CONCLUSIONS: This study demonstrated that naftopidil was clinically efficacious in the treatment of BPH patients with OAB.     

Physician perceptions of sexual dysfunction related to benign prostatic hyperplasia (BPH) symptoms and sexual side effects related to BPH medications

In a large-scale epidemiology study, 50% of aging men reported erectile dysfunction (ED) or ejaculatory dysfunction (EjD), with lower urinary tract symptoms (LUTS) an independent risk factor for each of these conditions. In light of the shift from urologists (UROs) to primary care/internal medicine physicians (PCPs) for the initial management of men with LUTS associated with benign prostatic hyperplasia (BPH), a survey was conducted to assess the perceptions of UROs and PCPs regarding sexual dysfunction (SD) in men with LUTS/BPH and the effects of BPH treatments (alpha(1)-adrenergic receptor antagonists (alpha-blockers) and 5alpha-reductase inhibitors (5ARIs)) on sexual function. The survey was mailed to 7500 UROs and 2500 PCPs, with 1275 (13%) surveys returned (1087 by UROs, 177 by PCPs and 11 by other specialty). Alpha-blocker monotherapy was the most common medication prescribed by both UROs (56%) and PCPs (47%). UROs estimated that 19% of their patients with LUTS/BPH experienced SD owing to their symptoms compared with the estimate of 27% by PCPs. UROs estimated that 19% of their patients experienced SD owing to their BPH medication compared with the PCP estimate of 24%. The incidence of EjD owing to BPH medications estimated by UROs (32%) was higher than that estimated by PCPs (22%); the rate of ED estimated by PCPs (34%) was higher than that estimated by UROs (23%). UROs were more aware than PCPs of the specific sexual side effects caused by alpha-blockers versus 5ARIs. These results suggest that physicians are underestimating the prevalence of SD in men with LUTS/BPH. As men with LUTS/BPH are at increased risk for SD, physicians should be especially cognizant of BPH treatment-related sexual side effects.     

前列腺增生症患者最小尿道开放压对剩余尿量的影响

目的　探讨前列腺增生症 (BPH )患者最小尿道开放压 (Pmuo)对剩余尿量的影响及其临床意义。方法　回顾性分析 12 7例BPH所致膀胱出口梗阻 (BOO)患者尿动力学检查和剩余尿量 (RUV)测定结果。根据Pmuo值将患者分为高Pmuo组和低Pmuo组 ,分别比较两组的RUV ,尿潴留发生率和有关尿动力学指标 ,并对RUV和Pmuo行相关分析。结果　①高Pmuo组的平均RUV显著高于低Pmuo组 (P <0 .0 5 ) ;②高Pmuo组有 2 3例 ( 2 6.4% )患者 ,低Pmuo组仅有 2例( 4 .4% )患者有急性尿潴留病史 ,差异有显著性 (P <0 .0 5 ) ;③高Pmuo组的平均PURR分级显著高于低Pmuo组 (P <0 .0 5 ) ;④相关分析显示Pmuo与RUV之间存在正相关 (r =0 .67,P <0 .0 5 )。结论　Pmuo对膀胱排空障碍及剩余尿的产生有明显影响。高Pmuo患者更易发生急性尿潴留。剩余尿量不能作为评价BPH患者逼尿肌功能和治疗预后的可靠指标     

Identifying Patients with Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia (LUTS/BPH) at Risk for Progression

Lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) are a slow but progressive disease. Men mainly progress due to worsening of symptoms, but they are also at risk of disease progression in terms of developing serious complications such as acute urinary retention (AUR), the need for prostate surgery and overall treatment failure or re-treatment. The major risk factors for progression based on community-based surveys and questionnaires among urologists seem to be a high post-void residual (PVR), a low maximum flow rate (Q_max) and severe symptoms. Older age and a large prostate volume/high prostate specific antigen (PSA) level are considered as intermediate risk factors. Data from randomised clinical trials (RCTs) in LUTS/BPH patients, however, suggest that in particular, higher PSA levels, as a proxy for prostate volume are associated with an increased risk for AUR and prostate surgery.The differences among community-based surveys, urologist opinions and RCTs in the perception of risk factors for LUTS/BPH disease progression show that it is crucial to determine the risk profile for disease progression of patients from real life practice (RLP). Patients at high or low/intermediate risk for LUTS/BPH progression should be identified for optimising the treatment on an individual basis.     

良性前列腺增生与下尿路症状及急性尿潴留的关系

目的　探讨前列腺移行带增生与下尿路症状 (LUTS)及急性尿潴留 (AUR)的关系。方法　将 119例良性前列腺增生(BPH)患者按有无AUR及LUTS严重程度分为 3组 :无AUR但LUTS较重者为A组 ,有AUR且LUTS较重者为B组 ,有AUR但LUTS较轻者为C组。对各组行I PSS评分 ,测量F PSA、T PSA及F/T PSA ;耻骨上经膀胱切除前列腺时观察移行带向膀胱内突出情况及前列腺部尿道狭窄情况 ,术后测定移行带质量 (TZW ) ,计算移行带体积 (TZV)。结果　各组F/T PSA、TZW、TZV差别无统计学意义 (P >0 .0 5 )。A、B两组I PSS评分及前列腺部尿道狭窄百分比明显高于C组 (P <0 .0 5 ) ;A组F PSA、T PSA、移行带向膀胱内突出百分比明显低于C组 (P <0 .0 5 ) ,而B、C两组这 3项指标无明显差异 (P >0 .0 5 )。A组F PSA、T PSA明显小于B组 (P <0 .0 0 1) ,I PSS、前列腺部尿道狭窄及移行带向膀胱内突出百分比与B组无显著性差异 (P >0 .0 5 )。结论　前列腺移行带质量及体积与BPH引起的LUTS及AUR的发生无关 ;而移行带的增生使前列腺部尿道狭窄、延长是BPH引起的LUTS的主要原因 ;移行带向膀胱突出则是AUR的主要原因。BPH合并AUR的患者F PSA及T PSA均明显增高 ,F/T PSA变化则不明显。     

Low incidence of acute urinary retention in the general male population: the triumph project

OBJECTIVE: To describe the incidence of acute urinary retention (AUR) in the general male population and in a population of men newly diagnosed with lower urinary tract symptoms suggestive of BPH (LUTS/BPH). METHODS: We performed a retrospective cohort study in the Integrated Primary Care Information (IPCI) database, a GP research database in The Netherlands, during the period 1995-2000. All males, > or =45 years, without a history of AUR or radical cystectomy were included in the study. In addition, we followed a sub-cohort of men, newly diagnosed with LUTS/BPH. AUR was defined as the sudden inability to urinate, requiring catheterization. RESULTS: Amongst 56,958 males with a mean follow-up of 2.8 years, 344 AUR cases occurred (incidence rate 2.2/1000 man-years) of whom more than 40% were precipitated. AUR was the first symptom of LUTS/BPH in 73 (49%) of the 149 AUR cases that occurred in men newly diagnosed with LUTS/BPH. The risk of AUR was 11-fold higher in patients newly diagnosed with LUTS/BPH (RR 11.5; 95%CI: 8.4-15.6) with an overall incidence rate of 18.3/1000 man-years (95%CI: 14.5-22.8). CONCLUSIONS: The incidence rate of AUR is low in the general population but substantial in a population of men newly diagnosed with LUTS/BPH. The incidence rate increases with age and AUR is precipitated in approximately 40% of all cases. Within the LUTS/BPH cohort, AUR is the first presenting symptom of BPH in 50% of all AUR cases.     

低功率钬激光与等离子剜除治疗中等体积前列腺增生的比较

目的对中等体积前列腺增生,通过比较低功率钬激光（LP-HoLEP）与等离子剜除（PKEP）的临床疗效,探讨低功率钬激光剜除前列腺增生的临床特点。 方法收集我院自2018年6月至2020年6月104例前列腺增生（30 ml1、IPSS、Q_max、RUV、PSA、剜除时间、粉碎时间、膀胱冲洗时间、术后尿管留置时间、住院时间、切除腺体质量、血红蛋白下降量等。统计两组患者术前及术后7 d、14 d及21 d尿白细胞升高例数,及术后6个月的IPSS评分、PSA、前列腺体积V₂等。 结果两组患者年龄、Hb、V₁、IPSS、Q_max、RUV、PSA、剜除时间、粉碎时间、腺体切除质量、血红蛋白下降值差异无统计学意义。LP-HoLEP组与PKEP组膀胱冲洗时间为（42.63±13.25）min和（51.67±11.65）min,术后尿管留置时间为（1.80±0.56） d和（2.23±0.83）d,术后平均住院天数为（2.90±0.70）d和（3.58±0.68）d,差异有统计学意义。两组患者尿白细胞升高例数随时间发生趋势性变化（F=132.842,P<0.05）,两组患者术后尿白细胞增多差异无统计学意义,（F=1.960,P=0.183）。随访6个月,LP-HoLEP和PKEP组IPSS评分降至（5.23±1.67）和（5.70±1.89）,PSA降至（1.17±0.40）和（1.04±0.37）ng/dl,前列腺体积V₂降至（15.93±2.18）ml和（15.25±2.73） ml。两组尿失禁和尿道狭窄等并发症发生率差异无统计学意义。 结论随访6个月,两组均能够有效剜除前列腺且降低PSA,同时改善LUTS,说明对治疗中等体积BPH均安全有效。LP-HoLEP虽然学习曲线较长,但可以减少膀胱冲洗、尿管留置及住院时间。因此,低功率钬激光剜除中等体积前列腺增生具有可行性且可进一步推广应用。     

前列腺柱状水囊扩裂术对良性前列腺增生合并尿潴留的治疗效果观察

目的探讨经尿道前列腺扩裂术对良性前列腺增生合并尿潴留患者治疗效果的影响。方法选取2017年8月至2018年8月收治的90良性前列腺增生患者为研究对象,按数字表法随机分为两组,每组各45例,对照组予以经尿道前列腺等离子电切术治疗,实验组予以经尿道前列腺扩裂术治疗,对比两组治疗前后美国国立卫生研究院慢性前列腺炎症状积分指数评分(NIH-CPS)、国际前列腺症状评分(IPSS)及相关前列腺症状改善情况。结果实验组手术用时、术中出血量、膀胱冲洗时间、术后留置尿管时间、住院时间均少于对照组,差异有统计学意义(P<0.05);实验组术后NIH-CPSI、IPSS评分较对照组低,差异有统计学意义(P<0.05);实验组术后最大尿流率(Qmax)较对照组高,残余尿量(RUV)、国际勃起功能障碍指数5(IIEF-5)评分较对照组低,差异有统计学意义(P<0.05);实验组并发症发生率是4.44%(2/45),较对照组低[17.78%(8/45)],差异有统计学意义(P<0.05)。结论经尿道前列腺扩裂术治疗良性前列腺增生可缩短手术时间,减轻手术创伤,对患者症状进行有效改善,且并发症少。