经尿道超脉冲等离子体腔内逆行剜除汽化切除术治疗良性前列腺增生

目的 探讨经尿道超脉冲等离子体腔内逆行剜除汽化切除术治疗良性前列腺增生的有效性和安全性.方法 2008年4月-2009年4月,应用Gyrus超脉冲等离子体行经尿道前列腺腔内逆行剜除汽化切除术124例,前列腺重量为(62.3±21.7)g.术中首先用电切镜鞘、电切环钝锐性相结合将前列腺增生腺体沿外科包膜逆行剥离、剜除,同...

Use of Superpulse Plasmakinetic Body in Transurethral Intracavitary Retrograde Enucleation and Vaporization Resection of the Prostate for the Treatment of Benign Prostatic Hyperplasia

Objective To evaluate the safety and clinical efficacy of superpulse plasmakinetic body in transurethral intracavitary retrograde enucleation and vaporization resection of the prostate（TUEVRP） for the treatment of benign prostatic hyperplasia（BPH）.Methods Between April 2008 and April 2009,Gyrus TUEVRP was performed on 124 patients with obstructive BPH whose mean prostatic weight was（62.3±21.7） g.The hyperplasia prostate glands were retrogradely dissected and enucleated along surgical capsule to the bladder neck by sharp and blunt dissection combination of the resectoscope tip or loop.Simultaneously,the blood supply of the gland was clamped.The changes of such indexes as operating time,perioperative blood loss,collected prostatic specimen weight,postoperative catheterization time,hospitalization time,prostatic specific antigen（PSA）,post voiding residual volume（PVR）,maximum urinary flow rate（Qmax）,international prostatic symptom score（IPSS）,and quality of life（QOL） were assessed.Results All surgeries were successfully carried out with an average operation time of（48.1±19.4） minutes ranged from 25 to 175 minutes.The mean collected prostatic specimen weight was（57.6±19.6） g ranged from 20.2 to 125.7 g.The blood loss was ranged from 45 to 350 ml,averaging at（86.2±20.7） mL during the operation.Blood transfusion was needed in only one case.Blood loss and operation time were increased and prolonged in accordance with the increase of prostatic volume and weight.The postoperative catheterization time was ranged from 2 to 5 days,averaging at 3.1±1.6.The mean hospitalization time was（5.8±1.4） days ranged from 5 to 8 days.All patients were followed up for 6 to 18 months.Qmax,PVR,IPSS and QOL-score six months after operation were significantly improved compared with those before operation（P0.05）.There were three cases of external urethral stricture,and they were treated with urethral dilatation successfully.Two cases of urinary incontinence recovered 1 and 6 months later,respectively,by traditional treatment.There were no cases of permanent urinary incontinence,reoperation for hemostasis,operative death,or transurethral resection syndrome.Conclusion TUEVRP is safe and clinically efficacious in the treatment of BPH,and is worthy of clinical promotion.