Efficacy Comparison Between DiVRP And DiVAP For Benign Prostatic Hyperplasia

BackgroundAs a emerging minimally invasive operation method,1470nm diode laser vaporization of the prostate has made great progression for treatment of surgical BPH.But the application of the side-firing laser fiber has some drawbacks,including energy attenuation,low tissue removal rate and pathological deficiency.By converting the laser emission from side-firing fiber to front-firing fiber and the tissue ablation mode from vaporization to vaporesection,A novel technique called 1470nm diode laser vaporesection of the prostate shows certain advantage for benign prostatic hyperplasia by comparing with 1470nm diode laser vaporization of the prostate.ObjectiveBy making a contrast with DiVAP,we aimed to assess the curative effect and security of Di VRP.MethodsA series of 54 vs 45 patients who underwent DiVRP vs DiVAP respectively,were analysed from Feb.2016 to Mar.2017,including operative time,HB decrease 2h after surgery,hemorrhage volume,catheter retention time,bladder irrigation time,lenth of hospital stay and complications after surgery;IPSS,QOL,RUV,Qmax before surgery and1 month and 1 year after surgery were studied.Results1 The differences were no significant between the two groups,which included baseline datas and preoperative complications(P>0.05).2 The differences were no significant between the two groups,which included HB decrease 2h after surgery,hemorrhage volume,bladder irrigation time,lenth of hospital stay(P>0.05).In comparison to DiVAP group,DiVRP group had shorter operative time[(51.62±11.90)min vs.(63.54±15.62)min,t=4.303,P=0.000]and catheter retention time[(2.40±0.93)d vs.(3.41±1.12)d,t=5.347,P=0.000]significantly.3 1 month and 1 year after surgery the IPSS,QOL,RUV,Qmax improved in both groups surgery significantly(P=0.000);while DiVRP group had less RUV and IPSS(P<0.05),there were no stastical difference in QOL and Qmax(P>0.05).The differences were insignificant in HB decrease 2h after surgery,hemorrhage volume,bladder irrigation time and lenth of hospital stay(P>0.05).4 Two groups of patients had no serious complications and evaluate the physical recovery of all patients 1-year follow-up visit postoperation.Di VRP group:Secondary hemorrhage(2/3.7%),Urge urinary incontinence(4/7.4%),Retrograde ejaculation(1/1.9%),Erectile dysfunction(2/3.7%);DiVAP group:Urge urinary incontinence(1/2.2%),Urinary tract infection(3/6.7%),Retrograde ejaculation(2/4.4%).Comparison of complications between two groups of patients were not significantly differences(P>0.05),and side effects of two groups showed no stastical difference[16.7%(9/54)vs.13.3%(6/45),x~2=0.212,P=0.645].ConclusionBoth DiVRP and DiVAP are safe and effective for treating BPH.Patients who received DiVRP are better than those who were treated with DiVAP,Di VRP has the advantage of shorter operative time and catheter indwelling time.