| Objective: To investigate the efficacy and safety of all-counterclockwise two-lobe thulium laser enucleation in the treatment of prostatic hyperplasia.Methods: According to the inclusion criteria and exclusion criteria,this article retrospectively analyzed the clinical data of patients hospitalized in the Department of Urology,Sixth Affiliated Hospital of Guangzhou Medical University from January2020 to December 2022 and diagnosed with benign prostatic hyperplasia undergoing transurethral prostate surgery,and a total of 95 patients who met the criteria were included.According to different surgical formulas,it was divided into two groups,including 47 cases in the all-counterclockwise two-lobe thulium laser enucleation group and 48 cases in the TURP group.Preoperative data of two groups of patients were recorded(age,body mass index,underlying disease,preoperative blood leukblood cell count,hemoglobin,blood creatinine,urine white blood cell count,prostate-specific antigen,prostate volume,maximum urine flow rate,residual urine output,international prostate symptom score,quality of life score,etc).Intraoperative data(operation time,amount of bleeding,amount of prostatectomy,intraoperative complications,etc.)Postoperative data(postoperative leukocyte count,hemoglobin,serum creatinine,decreased haemoglobin,postoperative indwelling urinary catheter,postoperative continuous bladder irrigation,postoperative hospital stay,postoperative short-term complications).Follow-up data(maximum urine flow rate,residual urine output,IPSS and Qo L scores at 1st,3rd and 6th months,and late postoperative complications)were used to evaluate the efficacy and safety of all-counterclockwise two-lobe laser enucleation by statistical analysis and observation of the two groups.Results: Preoperative observation index: there were no significant differences in age,body mass index value,preoperative blood leukocytes,preoperative hemoglobin,preoperative blood creatinine,preoperative urine leukocytes,preoperative PSA value,prostate volume,preoperative maximum urine flow rate,preoperative residual urine output,preoperative IPSS and preoperative Qo L comparison,P>0.05.Intraoperative observation indexes: there were significant differences in surgical enucleation time(All-counterclockwise two-lobe group 24.85±6.82 min vs TURP group32.77±7.72 min),intraoperative blood loss(All-counterclockwise two-lobe group18.65±10.58 ml vs TURP group 45.64±20.86 ml),prostate resection(Allcounterclockwise two-lobe group 52.68±18.55 g vs TURP group 33.91±19.62 g),postoperative hemoglobin decreased(All-counterclockwise two-lobe group6.08±3.27g/L vs TURP group 9.33 ± 7.60g/L)between the two groups,P<0.05.Compared with TURP,full-counterclockwise two-lobed laser prostatectomy has a shorter surgical time,less intraoperative bleeding,and a more thorough prostatectomy.Postoperative observation indexes: there were significant differences in postoperative indwelling catheter time(All-counterclockwise two-lobe group2.29±0.88 days vs TURP group 4.18±1.77 days),continuous bladder irrigation time(All-counterclockwise two-lobe group 0.70±0.80 days vs TURP group 2.10±1.29 days),postoperative hospital stay(All-counterclockwise two-lobe group 3.02±0.80 days vs TURP group 4.85±1.78 days)between the two groups,P<0.05.The postoperative catheteral indwelling time,postoperative continuous bladder irrigation time and postoperative hospital stay of all-counterclockwise two-lobe thulium laser enucleation were less than those in the TURP group.Postoperative follow-up indexes: there were no significant differences in postoperative maximum urine flow rate,postoperative residual urine volume,postoperative IPSS at the 1,3,6 month and postoperative Qo L at the 6 month between the two groups,P>0.05.There were significant differences in postoperative Qo L at the1 month(All-counterclockwise two-lobe group 3.59±0.68 points vs TURP group4.00±0.74 points)and 3 month(All-counterclockwise two-lobe group 3.06±0.89 vs TURP group 3.60±0.70 points)between the two groups,P<0.05.All-counterclockwise two-lobe thulium laser enucleation can achieve more satisfactory results than TURP within 3 months after surgery.Complications: There were no complications during the operation in both groups,and there were 4 patients(8.51%)with short-term complications after surgery in the all-counterclockwise two-lobe group,including 2 cases of transient urinary incontinence(4.25%),1 case of fever and dysuria(2.12%);There were 2 cases(4.25%)of postoperative late complications,including 1 case(2.12%)of urethral stricture and1 case of bladder neck contracture.There were 5 patients(10.41%)with short-term postoperative complications in the TURP group,including 1 case(2.08%)of transient urinary incontinence,blood transfusion and fever,and 2 cases(4.16%)of dysuria.There were 3 cases(6.25%)of postoperative late complications,including 2 cases of urethral stricture(4.16%)and 1 case of bladder neck contracture(2.08%).There was no significant difference in postoperative complications between the two groups,P>0.05.Postoperative complications can be improved with treatment.Conclusion: 1.The clinical effect of all-counterclockwise two-lobe thulium laser enucleation and TURP in the treatment of BPH is certain.2.All-counterclockwise two-lobe thulium laser enucleation was superior to TURP in operation time,intraoperative blood loss,prostate resection volume,postoperative catheteral indwelling time,postoperative continuous bladder irrigation time,postoperative hospital stay and Qo L at the first and third months after surgery.3.All-counterclockwise two-lobe thulium laser enucleation has the advantages of short operation time,high surgical efficiency,less bleeding and fast recovery. |
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