单极电切镜经尿道前列腺剜除术与经尿道前列腺切除术治疗前列腺增生症的临床对比研究

目的 临床比较单极电切镜经尿道前列腺剜除术(M-TUEP)与经尿道前列腺切除术(M-TURP)的近期疗效。方法 将具有手术指征的前列腺体积50ml～75ml的60例前列腺增生症(BPH)患者随机分为两组，分别行M-TUEP和M-TURP。监测、记录患者围手术期和术后3个月时的有关指标，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>0.05)。M-TUEP组术中出血量、手术时间、术后平均膀胱冲洗时间、留置尿管时间和住院时间、围手术期相关并发症均明显少于M-TURP组(P<0.05)。M-TUEP组切除腺体重量(40.5±13.3)g]明显多于M-TURP组(28.7±14.2)g](P<0.05)；术后3个月两组患者残余尿量、最大尿流率和IPSS评分差异无统计学意义(P>0.05)，而且均比术前明显改善(P<0.05)。结论 M-TUEP与M-TURP治疗BPH的近期疗效相似；但是M-TUEP的安全性好，切除效率高，并发症少；而且M-TUEP技术易于掌握，也符合卫生经济学原则，更适合在中国推广。

Clinical comparison of transurethral enucleation and resection of prostate for treatment of benign prostatic hyperplasia with monopolar resectoscope

Abstract  Objectives To compare the clinical viability and safety of transurethral enucleation of prostate (M-TUEP) and transurethral resection of prostate(M-TURP) for treatment of benign prostatic hyperplasia(BPH) with monopolar resectoscope. Methods 60 patients with BPH who had surgical indications and whose volume of prostate was 50ml～75ml were randomized into M-TUEP group and M-TURP group, with 30 patients in each. The preoperative international prostate symptom score(IPSS), the quality of life(QOL), Quantity of maximum flow rate(Qmax), postvoid residual urine volume(PVR), the perioperative operation time, bleeding, weight of resected prostate, mean bladder irrigating time, catheterization time, and hospitalization were recorded. Three months after the operation, the correlative complications, PVR, Qmax and IPSS were observed. All results were statistically analyzed. Results There was no statistically significant difference in preoperative factors between the two groups (P>0.05). The mean operation time, hemorrhage, bladder irrigating time, catheterization time, hospitalization and perioperativelly correlative complications  were significantly less in the M-TUEP group than in the M-TURP group(P<0.05). The mean weight of resected prostate was more heavy in the M-TUEP group than in the M-TURP group(P<0.05). There were no significant differences in urinary incontinence, urethral stricture, and retrograde ejaculation between the two groups(P>0.05), PVR, IPSS and Qmax were significantly improved (P<0.05) at three months postoperatively. Conclusions M-TUEP has the same short-term efficacy as M-TURP for the treatment of symptomatic BPH. The advantages of TUEP is higher safty and efficiency of resection and less complications than M-TURP. And M-TUEP is easy to be mastered for urological surgeons and more fit to be popularized in China than enucleation of prostate with lasers.