经尿道前列腺电切术与汽化切除术的并发症分析

目的 分析经尿道前列腺电切术（TURP）与经尿道前列腺汽化切除术（TVP）术中、术后常见并发症，进一步提高手术安全性和有效性。方法 回顾分析经尿道前列腺切除术4156例，其中TURP1056例，TVP3100例。比较2组患者术中、术后早期和远期并发症的发生率。结果 TURP与TVP平均手术时间分别为62min和54min，平均切除组织21．2g和36．7g。因术中出血而需输血者分别为14．1％和0．2％（P〈0．01），电切综合征（TURS）2．7％和0．9％（P〈0．01），包膜穿孔尿外渗3．7％和0．8％，术后出血2．2％和0．2％，尿路感染4．0％和5．7％，尿道狭窄2．5％和2．8％，膀胱颈部挛缩2．2％和2．1％，勃起功能障碍7．0％和2．3％（P〈0．01），逆行射精为45．0％和45．6％，永久性尿失禁各1例。结论 TURP与TVP均为良性前列腺增生安全而有效的外科治疗方法。但TURP术中出血、TURS、包膜穿孔尿外渗、术后出血、勃起障碍发生率明显高于TVP，而TVP尿道狭窄和膀胱刺激症状发生率略高于TURP组。

Analysis of complications of transurethral resection of the prostate and transurethral electrovaporization of the prostate

Objective To analyze the common complications during and after transurethral resection of the prostate (TURP) and transurethral electrovaporization of the prostate (TVP) ,and to further improve the efficacy and safety of these procedures. Methods Retrospective analysis was performed in 4156 cases of transurethral prostatectomy, including 1056 cases of TURP and 3100 cases of TVP. Intraoperative, early and late postoperative complications of the 2 groups were analyzed. Results For TURP and TVP groups, the mean operative time was 62 min and 54 min, respectively; the mean resected tissue was 21. 2 g and 36. 7 g; blood transfusion was needed in 14. 1% and 0. 2% of the cases. Transurethral resection syndrome (TURS) occurred in 2. 7% and 0. 9% , urine extravasation in 3. 7% and 0. 8% .postoperative bleeding in 2. 2% and 0. 2% .urinary tract infections in 4. 0% and 5.7% .urethral stricture in 2. 5% and 2. 8% .bladder neck contracture in 2.2% and 2. 1% .erectile dysfunction (ED) in 7.0% and 2.3% .retrograde ejaculation in 45.0% and 45. 6% of the cases,respectively;and permanent urinary incontinence in 1 case of each group. Conclusions Both TURP and TVP are safe and effective surgical treatment for symptomatic benign prostatic hyperplasia. The incidence rates of intra- and post-operative bleeding, TURS, extravasation, ED of TURP are significantly higher than those of TVP;while the rates of urethral stricture and voiding stimulating symptoms of TVP are slightly higher than those of TURP.