目的:探讨等离子经尿道前列腺剜切术(TUERP)与经尿道前列腺电切术(TURP)治疗高危良性前列腺增生(HBPH)的临床疗效。方法:选取我院于2018年6~12月收治的HBPH患者60例,并按照随机分配原则分为两组,试验组和对照组各30例,对照组患者行TURP...目的:探讨等离子经尿道前列腺剜切术(TUERP)与经尿道前列腺电切术(TURP)治疗高危良性前列腺增生(HBPH)的临床疗效。方法:选取我院于2018年6~12月收治的HBPH患者60例,并按照随机分配原则分为两组,试验组和对照组各30例,对照组患者行TURP治疗,试验组患者行TUERP治疗,记录并比较两组患者的手术时间、手术失血量、术后并发症及切除的前列腺体积等临床指标。结果:试验组患者的手术时间[(47.5±16.1) min vs(76.2±15.9) min]、手术失血量[(60.5±25.4) ml vs(93.7±33.6) ml]均显著低于对照组(P<0.05),而切除的前列腺体积显著大于对照组[(42.3±12.2) g vs(30.6±8.5) g](P<0.05),术后并发症如出血、尿失禁、尿道狭窄等例数均少于对照组。结论:TUERP与TURP治疗HBPH均具有较好临床效果,但TUERP的手术失血量较少,手术时间短,术后并发症少,切除的前列腺体积更大,手术创伤更小,更适合用于治疗HBPH。展开更多
目的探讨经尿道柱状水囊前列腺扩开术(transurethral columnar balloon dilation of prostate, TUDP)治疗老年前列腺增生患者的效果。方法老年前列腺增生患者60例,随机分为观察组和对照组各30例,观察组行TUDP手术,对照组行经尿道等离子...目的探讨经尿道柱状水囊前列腺扩开术(transurethral columnar balloon dilation of prostate, TUDP)治疗老年前列腺增生患者的效果。方法老年前列腺增生患者60例,随机分为观察组和对照组各30例,观察组行TUDP手术,对照组行经尿道等离子前列腺剜除术(transurethral enucleation and resection of prostate, TUERP)。比较2组手术时间、膀胱冲洗时间、尿管留置时间、术后住院时间和术中出血量;比较2组术后性功能指标勃起功能障碍和逆行射精发生率及勃起功能国际问卷5(International Index of Erectile Function-5, IIEF-5)评分;比较2组术后国际前列腺症状评分(International Prostate Symptom Score, IPSS)、生活质量指数(quality of life index, QOL)、最大尿流率(maximum urine flow rate, Qmax)、剩余尿量(post-void residual urine, PVR);比较2组术后并发症发生率。结果观察组手术时间、膀胱冲洗时间、尿管留置时间、术后住院时间和术中出血量均少于对照组(P<0.05);术后6个月,观察组IIEF-5评分[(25.21±5.70)分]、Qmax[(18.2±2.9)mL/min]高于对照组[(22.34±6.90)分、(15.0±2.5)mL/min](P<0.05),IPSS[(9.5±3.1)分]、QOL[(1.5±1.2)分]、PVR[(27.8±15.1)L]和并发症发生率(3.3%)低于对照组[(12.4±6.3)分、(2.9±1.2)分、(33.6±14.2)L、26.7%](P<0.05),勃起功能障碍和逆行射精发生率(3.3%、3.3%)与对照组(6.7%、6.7%)比较差异无统计学意义(P>0.05);2组术后6个月勃起功能障碍和逆行射精发生率、IPSS、QOL、PVR均低于术前(P<0.05),IIEF-5评分和Qmax均高于术前(P<0.05)。结论 TUERP和TUDP均可改善老年前列腺增生患者的临床症状,提升性能力;但TUDP手术创伤小,并发症少,提高性能力效果更好。展开更多
<strong>Introduction:</strong> Lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) is one among the foremost common diseases affecting the aging man with, almost 80% of the ...<strong>Introduction:</strong> Lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) is one among the foremost common diseases affecting the aging man with, almost 80% of the lads greater than 70 affected. BPH is caused by unregulated proliferation within the prostate, which may cause physical obstruction of the prostatic urethra and result in anatomic bladder outlet obstruction (BOO). Transurethral resection of the prostate (TURP) has been the historical gold standard up till now to which all endoscopic procedures for benign prostatic hyperplasia (BPH) are compared with a mean hospital stay of three days. This surgery although efficacious has been related with increased morbidity and increased day case failure rates as compared to newer techniques. These shortcomings have prompted the utilization of newer methods like Transurethral enucleation and resection of the prostate (TUERP), Holmium laser enucleation of the prostate (HoLEP) and Thulium laser enucleation of the prostate (ThuLEP). This review will discuss the enucleation techniques, advantages and therefore the predictive factors for a successful day case prostate surgery. <strong>Materials and Methods:</strong> During this review, we discuss the newer techniques utilized in day case BPH surgery as well as the predictive factors for a successful BPH surgery, both enucleation, benefits and morcellation are covered also. <strong>Results:</strong> TUERP, ThuLEP and HoLEP have literature supporting the advantages of these techniques, which demonstrates its ability in day case BPH surgeries in specially selected cases with favorable factors and a 61% overall success rate. <strong>Conclusion:</strong> TUERP, ThuLEP and HoLEP Have proven to show favorable outcomes in day case BPH surgery with urologist’s experience, prostate size, duration of operation, age, use of anticoagulants, morning theatre list and ASA score being the key factors for a successful day case surgery.展开更多
文摘目的:探讨等离子经尿道前列腺剜切术(TUERP)与经尿道前列腺电切术(TURP)治疗高危良性前列腺增生(HBPH)的临床疗效。方法:选取我院于2018年6~12月收治的HBPH患者60例,并按照随机分配原则分为两组,试验组和对照组各30例,对照组患者行TURP治疗,试验组患者行TUERP治疗,记录并比较两组患者的手术时间、手术失血量、术后并发症及切除的前列腺体积等临床指标。结果:试验组患者的手术时间[(47.5±16.1) min vs(76.2±15.9) min]、手术失血量[(60.5±25.4) ml vs(93.7±33.6) ml]均显著低于对照组(P<0.05),而切除的前列腺体积显著大于对照组[(42.3±12.2) g vs(30.6±8.5) g](P<0.05),术后并发症如出血、尿失禁、尿道狭窄等例数均少于对照组。结论:TUERP与TURP治疗HBPH均具有较好临床效果,但TUERP的手术失血量较少,手术时间短,术后并发症少,切除的前列腺体积更大,手术创伤更小,更适合用于治疗HBPH。
文摘目的探讨经尿道柱状水囊前列腺扩开术(transurethral columnar balloon dilation of prostate, TUDP)治疗老年前列腺增生患者的效果。方法老年前列腺增生患者60例,随机分为观察组和对照组各30例,观察组行TUDP手术,对照组行经尿道等离子前列腺剜除术(transurethral enucleation and resection of prostate, TUERP)。比较2组手术时间、膀胱冲洗时间、尿管留置时间、术后住院时间和术中出血量;比较2组术后性功能指标勃起功能障碍和逆行射精发生率及勃起功能国际问卷5(International Index of Erectile Function-5, IIEF-5)评分;比较2组术后国际前列腺症状评分(International Prostate Symptom Score, IPSS)、生活质量指数(quality of life index, QOL)、最大尿流率(maximum urine flow rate, Qmax)、剩余尿量(post-void residual urine, PVR);比较2组术后并发症发生率。结果观察组手术时间、膀胱冲洗时间、尿管留置时间、术后住院时间和术中出血量均少于对照组(P<0.05);术后6个月,观察组IIEF-5评分[(25.21±5.70)分]、Qmax[(18.2±2.9)mL/min]高于对照组[(22.34±6.90)分、(15.0±2.5)mL/min](P<0.05),IPSS[(9.5±3.1)分]、QOL[(1.5±1.2)分]、PVR[(27.8±15.1)L]和并发症发生率(3.3%)低于对照组[(12.4±6.3)分、(2.9±1.2)分、(33.6±14.2)L、26.7%](P<0.05),勃起功能障碍和逆行射精发生率(3.3%、3.3%)与对照组(6.7%、6.7%)比较差异无统计学意义(P>0.05);2组术后6个月勃起功能障碍和逆行射精发生率、IPSS、QOL、PVR均低于术前(P<0.05),IIEF-5评分和Qmax均高于术前(P<0.05)。结论 TUERP和TUDP均可改善老年前列腺增生患者的临床症状,提升性能力;但TUDP手术创伤小,并发症少,提高性能力效果更好。
文摘<strong>Introduction:</strong> Lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) is one among the foremost common diseases affecting the aging man with, almost 80% of the lads greater than 70 affected. BPH is caused by unregulated proliferation within the prostate, which may cause physical obstruction of the prostatic urethra and result in anatomic bladder outlet obstruction (BOO). Transurethral resection of the prostate (TURP) has been the historical gold standard up till now to which all endoscopic procedures for benign prostatic hyperplasia (BPH) are compared with a mean hospital stay of three days. This surgery although efficacious has been related with increased morbidity and increased day case failure rates as compared to newer techniques. These shortcomings have prompted the utilization of newer methods like Transurethral enucleation and resection of the prostate (TUERP), Holmium laser enucleation of the prostate (HoLEP) and Thulium laser enucleation of the prostate (ThuLEP). This review will discuss the enucleation techniques, advantages and therefore the predictive factors for a successful day case prostate surgery. <strong>Materials and Methods:</strong> During this review, we discuss the newer techniques utilized in day case BPH surgery as well as the predictive factors for a successful BPH surgery, both enucleation, benefits and morcellation are covered also. <strong>Results:</strong> TUERP, ThuLEP and HoLEP have literature supporting the advantages of these techniques, which demonstrates its ability in day case BPH surgeries in specially selected cases with favorable factors and a 61% overall success rate. <strong>Conclusion:</strong> TUERP, ThuLEP and HoLEP Have proven to show favorable outcomes in day case BPH surgery with urologist’s experience, prostate size, duration of operation, age, use of anticoagulants, morning theatre list and ASA score being the key factors for a successful day case surgery.