Comparison Of Transurethral Columnar Balloon Dilation Of Prostate And Plasmakinetic Resection For Benign Prostatic Hyperplasia

Objective: to compare the short-term clinical efficacy and safety of Transurethral Balloon dilatation of Prostate(TUCBDP)and Transurethral plasmakinetic resection of the Prostate(TUPKP)in the treatment of Benign prostatic hyperplasia.Methods: This study was a prospective,open,randomized controlled,multi-center clinical trial.non-inferiority test was used for statistical analysis.Including eligible cases diagnosed as Benign prostatic hyperplasia from July 2017 to December 2018 at Hubei Provincial Hospital of Traditional Chinese Medicine,Wuhan University Zhongnan Hospital,Xianning Central Hospital,Wuhan Wuchang Hospital,among them,the observation group received transurethral dilatation of the Prostate,the control group received transurethral resection of the prostate.A total of 59 cases were included,(1)the data of two groups of patients before operation were analyzed and compared,including Age,height,weight,duration of disease,vital signs and general physical examination,blood routine,urine routine,liver function,electrolyte,renal function,coagulation function,electrocardiogram,prostate,serum prostate specific antigen,international prostate symptom score(IPSS),quality of life index score(QOl),international erectile function index score(IIEF-5);(2)the follow-up data of 1 month,3 months and 1 year after operation were collected,including vital signs and general physical examination,pain score(Vas),international prostate symptom score(IPSS),quality of life score(Qol),international erectile function index score(IIEF-5),maximum flow rate(QMAX),residual urine(PVR),the differences of IPSS score,QOL score,IIEF-5 score,maximum flow rate(QMAX)and residual urine(PVR)between the two groups were compared(3)to compare the number of bleeding cases,vas score,hospitalization time,bladder irrigation time,indwelling catheterization time,operation time and the number of postoperative adverse events between the two groups to analyze the safety of the two methods.RESULT:1.There was no statistical difference between the two groups(p> 0.05),which showed that the general condition of each group before operation was balanced and comparable.2.The scores of IPSS and Qol in the Group of 1 month,3 months and 1 year after operation were compared with those before operation(p< 0.05).The scores of IPSS and Qol in the Group of 1 month,3 months and 3 months after operation were compared with those before operation(p<0.05),the effect of operation was good,the quality of life of patients was improved obviously,and the patients were satisfied with urination.3.The maximal flow rate(Qmax)and residual urine(PVR)were significantly improved in 1 month,3 months and 1 year after operation,and decreased significantly after operation compared with before operation.4.There was no significant difference in Qmax and PVR between the two groups in 1 month and 3 months postoperatively,which indicated that the curative effect was equal.5.The blood loss of the two groups was compared(<0.05),which showed that the blood loss of the expanded group was less than that of the electrotomy group.6.There was no difference between the two groups in Vas(p> 0.05),24 hours after operation and 24 hours after operation(p<0.05),and 7 days after operation and 24 hours after operation(p< 0.05).7.The time of hospitalization,bladder irrigation and indwelling catheterization were compared between the two groups(p> 0.05),and there was no difference between the two groups(p<0.05),the results showed that the expanded group had more advantage than the electrotomy group in the operation time.8.The number of adverse events was 3 cases,all of which were urgent urinary incontinence,5 cases in dilation group,1 case of bleeding and 4 cases of urgent urinary incontinence.There was no significant difference in the incidence of the two groups.9.There were no obvious abnormity in the laboratory examination(blood routine examination,liver and kidney function,electrolyte and so on)after operation and 2 hours and 10 days after operation,and no massive hemorrhage(blood volume ≥1000ML)after operation,no serious adverse events occurred in both groups.CONCLUSION:1.There was no significant difference in Qmax,IPSS and QOL before Operation(P & GT;0.05)between the dilation group and the electrotomy group.2.There was no significant difference between the two groups in one month,three months and one year after operation,which indicated that the two groups were effective in the treatment of BPH.3.There was no significant difference between the two groups,which showed that the two methods had the same curative effect and were not inferior.4.There was no significant difference in the safety index and no serious adverse events between the two groups,which indicated that the two methods were equally safe.5.The bleeding volume,urinary incontinence degree and function protection of the expanded group were better than that of the electrotomy group.6.The expanded group had shorter operative time and less intraoperative risk than the electrotomy group.