Clinical Comparative Study Of Transurethral Bipolar Plasma Prostatectomy And Transurethral Holmium Laser Enucleation

Objective: By comparing the safety and effectiveness of transurethral bipolar plasma prostatectomy with transurethral holmium laser enucleation,this study provides some theoretical basis for the selection and popularization of prostatic enucleation.Methods: A retrospective analysis was made of 255 cases of BPH treated surgically in the First Affiliated Hospital of Guangxi University of Chinese Medicine from January 2015 to January 2018.They were divided into three groups according to the operation methods.96 cases of patients undergoing transurethral bipolar plasma prostatectomy were taken as control group(PKRP group),74 cases of patients undergoing transurethral bipolar plasma prostatectomy(PKEP group)and 85 cases of patients undergoing transurethral holmium laser enucleation(Ho LEP group)were taken as observation group.The perioperative conditions,the improvement of urinary function and the occurrence of complications in the three groups were compared and analyzed.Results: There was no significant difference in preoperative general data among the three groups(P>0.05).There were significant differences in operation time,bleeding volume,bladder irrigation time,indwelling time of urinary catheter and hospitalization time among the three groups(P<0.05),all of which were PKRP group > PKEP group > Ho LEP group,and there were significant differences between the two groups.The Qmax,PVR,IPSS and QOL of the three groups were significantly improved at 3 months and 6months after operation(P<0.01).There was no significant difference in Qmax,PVR,IPSS and QOL at 3 months after operation compared with 6 months after operation(P>0.05).There was no significant difference in Qmax,PVR,IPSS and QOL between the three groups(P>0.05).There was no significant difference in the incidence of intraoperative complications among the three groups(P>0.05).The incidence of postoperative complications was significantly different except for the incidence of transient urinary incontinence and postoperative bleeding(P<0.01),but there was no significant difference among the three groups(P>0.05).The incidence of postoperative transient urinary incontinence was Ho LEP group > PKEP group > PKRP group,and the incidence of postoperative bleeding was Ho LEP group.Group < PKEP group < PKRP group,the incidence of transient urinary incontinence and postoperative bleeding were significantly different between Ho LEP group and PKRP group(P<0.05).Conclusion(s): In terms of surgical safety,Ho LEP and PKEP are generally better than PKRP,while Ho LEP is safer than PKEP.Ho LEP and PKEP are generally better than PKRP in terms of short-term effectiveness of surgery,while Ho LEP is more effective than PKEP.In terms of the main effect of surgery,the three are comparable,and the merits and demerits are still controversial.In terms of complications,the incidence of total complications of PKRP,Ho LEP and PKEP during and after operation is not significantly different.The incidence of transient urinary incontinence among the three complications after operation is different within 2 weeks,but the degree of recovery is the same,the incidence of transient urinary incontinence after 2 weeks is the same,the rate of bleeding after operation is lower,and the incidence of other complications is not significantly different.Generally speaking,Ho LEP is safer and more effective than PKEP and PKRP due to its advantages of both enucleation and holmium laser.It is more hopeful that Ho LEP will become a new "gold standard".