经尿道前列腺电汽化术300例近期随访

目的　评价经尿道前列腺电汽化术 (TVP)。方法　对我院以TVP治疗的 30 0例BPH患者进行随访。病人年龄 5 4～ 88岁 ,平均 71.5岁 ;前列腺重 2 0～ 138g ,平均 (47.3± 35 .6 )g。均有手术适应证。 结果　手术平均时间为 (36± 19)min ,2 44例 (82 .3 % )术中出血在 5 0ml以内 ,无TUR综合征。术后 1～ 4d拔除尿管。随访 6个月 ,PFR、IPSS和QOL显著改善。有 2 3例(7.7% )出现暂时性尿失禁 ,2周至 3个月恢复。 6 0 /78例 (77% )逆行射精。结论　TVP极有可能是取代TURP成为BPH的理想手术方式

Transurethral electrovaporization of the prostate(TVP) with vaportoom

Objectives　Transurethral resection of the prostate(TURP) is still considered the ‘Gold standard’ in the treatment of BPH, although it causes some morbidity such as bleeding, TUR-syndrome. Transurethral electrovaporization of the prostate (TVP) is a new, minimally invasive and promising alternative to standard TURP in the treatment of BPH. This study is aimed to evaluate the effect and safety of TVP for the symptomatic BPH.Methods　TVP was carried out using an standard irrigating resectoscope with vaportoom (Circon Acmi). Irrigating fluids is 5% glucose solution.Over a 18 month period,300 consecutive men (mean age 71.5 years, range 54-88) with symptomatic BPH (mean prostate volume 47.3±35.6 g, range 20-138) fulfilled the conventional criteria for a prostatectomy were treated with TVP.Preoperative and postoperative International Prostate Symptom Score (IPSS),Quality of Life(QOL),Maximum flow rates (PFR) and complications were recorded in each patient.Results　The PFR increased from 4.4 to 18.6, 21.7, and 21.5 ml/s at 1,3,and 6 months, respectively. IPSS decreased from 25.5 to 5.1,5.0,and 3.2 at 1,3,and 6 months, respectively. Mean operative duration is 35 min (range 15-105). None of the patients required a blood transfusion. TUR-syndrome and sphincteric incontinence were not found. Catheters removed in 24-96 h following surgery.19/300 patients experienced retention and need 2-5 days recatheterization. 60/78(77%) patients had retrograde ejaculation.Conclusions　TVP is an effective alternative in the treatment of symptomatic BPH, with the advantages of minimal bleeding, no need for blood transfusion and no TUR-Syndrome.