Comparison Of The Clinical Effects Between Transuretheral Resectoscope Enucleation Of Prostate And Transuretheral Resection Of Prostate For Benign Prostatic Hyperplasia

Objective Benign prostatic hyperplasia (BPH) is a common disease of the old man. The less BPH can be observed and adopted drug treatment.However, the midst and severe BPH must enforce all sorts of operation.Every operational method has its advantage and disadvantage.Transurethral resection of the prostate (TURP) was considered as a gold standard of treating BPH, but the method has the limitation of itself. Transuretheral resectoscope enucleation of prostate possess the more ascendant than TURP.The essay summaried and analysesed the clinic treated result of BPH through transuretheral resectoscope enucleation of prostate. To compare the clinical effects of transuretheral resectoscope enucleation of prostate with transuretheral resection of prostate for benign prostatic hyperplasia.Method From June 2006 to June 2008,105 cases with benign prostatic hyperplasia was randomized into the group of transuretheral resectoscope enucleation of prostate(TREP)(n=51)and the group of transuretheral resection ofprostate(TURP)(n=54). All operations were performed by associate chief physician who had grasped proficient transuretheral resectoscope enucleation of prostate and TURP.The aimis in order to lessen difference that was induced by different operator.The significant markers and therapeutic results were recorded and analyzed, which includes such as Qmax,Pdet/Qmax,IPSS,QOL and at the third month postoperatively.Operation time,intraoperative hemorrhage,weight of resected prostate and difference between measured weight by type-B ultrasonic and weight of actual resected prostate were compared.The short-term therapeutic effects were compared between the two groups.Result compared with the TURP group, the TREP group had less intraoperative hemorrhage ((176.27±86.28)ml vs (242.59±130.11)ml,t=3.059,P=0.003),more weight of resected prostate ((40.31±20.33)g vs (26.29±14.93) g,t=-4.043,P=0.000) and less difference between measured weight by type-B ultrasonic and weight of actual resected prostate [(30.34±19.18)g vs (37.53±19.76) g,t=1.89,P=0.041].The differences were significant between the two groups(P<0.05).Operation time of two groups was similar [(51.33±19.83) min vs (49.04±27.54) min,t=-0.488,P=0.627].No significant difference was found between the two groups(P> 0.05).There were no statistical significance between the post-operative maximun urine flow rates and hospital days between the two groups.Conclusion1. transuretheral resectoscope enucleation of prostate is as effective as TURP for the treatment of symptomatic BPH.2. Compaired with transuretheral resection of prostate,transuretheral resectoscope enucleation of prostate for benign prostatic hyperplasia has the advantages of less intraoperative hemorrhage and more thorough resection.3. The operator who sufficiently recognize the relative position between the loop and external urethral sphincter and affiliate the method of back cutting can avoid to injure wall of urinary bladder and induce vesical perforation and hemorrhea and urinous infiltration,especially when to undermine the hyperplastic glandular organ of neck of bladder.4. The operator who had correctly comprehended the position and appearance of the gap between the hyperplastic glandular organ and surgical coating and skillfully grasped TURP can practice transurethral resectoscope enucleation of prostate, but the learning cycle is relatively longer.