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...

Comparison of transurethral bipolar plasmakinetic prostatectomy and holmium laser enucleation of the prostate for the treatment of large-size benign prostatic hyperplasia: a randomized controlled study

ObjectiveTo compare the safety and efficacy between transurethral bipolar plasmakinetic prostatectomy (TUPKP) and holmium laser enucleation of the prostate (HoLEP) for the treatment of large-size (>80 ml) BPH. MethodsIn Foshan Fosun Chancheng Hospital, from January 2017 to January 2021, patients of BPH, prostate size >80 ml, were enrolled in this randomised controlled study, which were classified as TUPKP group (37 patients) and HoLEP group (35 patients). IPSS, QOL, Q_max and RUV were assessed preoperatively and postoperatively at 1 and 6 months between the two groups. Operative time, blood loss, catheterization duration, postoperative hospital stay and complications were all recorded. ResultsSurgeries were successfully achieved in one stage in all patients. Perioperative results showed that operative time was significantly shorter in HoLEP group as well as catheterization duration and postoperative hospital stay (P<0.05, respectively), while there was no statistical difference between the two groups in terms of postoperative bladder irrigation. The prostate tissue removed in the HoLEP group was more than that in the TUPKP group (P<0.05), and the blood loss was less in the HoLEP group (P<0.05). The IPSS, RUV and QOL in each group at 1 month and 6 months were significantly lower than those before operation (P<0.05), meanwhile, Q_max of the two groups were significantly higher than those before operation (P<0.05). The improvement of IPSS and QOL were more obvious at 1 month in the HoLEP group (P<0.05, respectively). However, there were no significant difference between the two groups in IPSS, Q_max, RUV and QOL at 6 months (P>0.05). There was no significant difference in the incidence of intraoperative and postoperative complications between the two groups (P>0.05). ConclusionsHoLEP and TUPKP are both safe and effective for the treatment of large-size benign prostatic hyperplasia. Compared to TUPKP, HoLEP provides a superior operative efficiency and bleeding control, it needs shorter catheterization duration and hospital stay.