The Clinical Efficacy And Safety Of TmLRP For The Treatment Of High-risk Senior Patients With Benign Prostatic Hyperplasia

Objective: Compared with transurethral resection of the prostate(TURP),to evaluate the clinical efficacy and safety of thulium laser vaporesection of prostate(Tm LRP)for the treatment of high risk senior patients with benign prostatic hyperplasia.In order to provide a more suitable minimally invasive surgery for patients with high risk of benign prostatic hyperplasia in clinical practice.Methods: A retrospective analysis of 86 patients with benign prostatic hyperplasia,who were treated by thulium laser vaporesection of prostate or transurethral resection of the prostate in Guizhou People’s hospital from February 2012 to February 2015.Patients include transurethral resection of the prostate treatment of 44 cases(TURP group);Those patients include thulium laser vaporesection of prostate treatment of 42 cases(Tm LRP group).Aseptic isosotic liquid was used as flushing fluid.We collected clinical relevant data in the perioperative period including international prostate symptom score(IPSS),quality of life score(QOL),maximum flow rate(Qmax),postvoid residual volum(PVR),operation time,postoperative bladder irrigating time,postoperative indwelling catheter time,postoperative hospitalization time,the level of preoperative and postoperative serum sodium and serum potassium,the changes of hemoglobin content and the complications.By postoperative 3 month,12 months and 36 months review index of IPSS,QOL,Qmax and PVR,process statistical analysis,then compare the long term effects of the two surgical methods.Results: The two groups of patients all completed the operation,and 11 patients were lost in total.There were no statistically significant difference in clinical relevant data before the operation including ASA classification,age,prostate volume,IPSS,QOL score,Qmax and PVR(P>0.05).TURP group and Tm LRP group mean operative time was 80.46±23.0 minutes and 89.33±16.11 minutes,both groups operative time were statistical difference(P < 0.05).Postoperative bladder irrigating time,postoperative indwelling catheter time and postoperative hospitalization time were significantly less in Tm LRP group than TURP(P < 0.05).There was no significant difference in hemoglobin,serum sodium ion and serum potassium between TURP group and Tm LRP group before operation(P>0.05),but there was statistical difference after operation(P<0.05).Compare two groups’ various surgical complications,the difference was statistically insignificant(P>0.05).Two groups of patients in 3 months,12 months,36 months follow-up IPSS,QOL,Qmax,PVR and preoperative comparison were statistically significant.Although there was no significant difference between the two groups in 3 months and 12 months follow-up,the difference in 36 months,except PVR,was statistically insignificant(P>0.05).Conclusion: Tm LRP is an effective minimally invasive treatment for benign prostatic hyperplasia.Compared to TURP,Tm LRP has the advantages of less blood loss,faster recovery,shorter hospitalization days and the long-term and stable curative effect,which is an even better minimally invasive option for elderly high-risk benign prostatic hyperplasia patients.