经尿道双极等离子电汽化治疗前列腺增生症45例报告

目的:探讨经尿道双极等离子电汽化(PKRP)治疗前列腺增生症的有效性及安全性。方法:采用英国Gyrus经尿道双极等离子汽化电切镜系统治疗前列腺增生症(BPH)45例。年龄57~83岁,平均70岁,前列腺重量20~151g,平均(53.9±28.5)g;均有手术适应证,术后随访1~6月。结果:PKRP手术时间(55±25)min(25~100min),切除前列腺组织重量(31±7)g(20~50g),术后2~6d拔除导尿管,术中有1例需要输血(800ml),无TUR综合征发生,术后2例尿道外口狭窄,经尿道扩张2周后尿线变粗,1例暂时性尿失禁者进行提肛锻炼,随访1个月后恢复。术后最大尿流率(Qmax)由术前的(9.4±3.9)ml·s-1升至(19.2±3)ml·s-1,国际前列腺症状评分(IPSS)由术前的25.2下降至5.4,生活质量评分(QOL)由术前的5.1下降至1.1。该项指标手术前后比较均有显著改善。结论:用等离子体双极电切进行经尿道前列腺切除是一种安全、有效的手术方式。

Transurethral Resection of the Hyperplastic Prostate Using Bipolar Plasmakinetic Electrovaporization Technique

Objective: To assess the efficacy and safety of transurethral resection of the prostate with bipolar plasmakinetic (PKRP) in the treatment of benign pr ostatic hyperplasia (BPH). Methods: 45 patients with symptomati c BPH were treated with bipolar plasmakinetic electrovaporization with saline irrigation. International prostate symptom score (IPSS) with a quality of life ( QOL) scoring questionnaire, uroflowmetry (maximum flow rate; Qmax), residual uri ne volume and prostate specific antigen (PSA) measurements had been performed be fore surgery. All patients were followed up for 1~6 months postoperatively. Results: The mean operative time was (55±25) min (range from 25 to 100 min), the mean weight of the resected tissue was (31±7) g (range from 20 t o 50 g), one case needed blood transfusion during the operation (800 ml), and no transurethral resection syndrome occurred. The mean catheterization time was 4 days (2~6 d). Urethral stricture occurred in 2 cases postoperation, and was trea ted by urethral dilatation for 2 weeks. The Qmax increased from (9.4±3.9) to (1 9.2±3) ml·s~-1, the IPSS decreased from 25.2 to 5.4, and the QOL decrease d from 5.1 to 1.1 after 6 months. Postoperative values of IPSS, QOL and Qmax showed significant improvement compared with preoperative values (P<0.05). Conclusion: Transurethral bipolar plasmakinetic resection of t he prostate is an effective and safe method with fewer complications. It is reco mmended for the treatment of BPH.