The Practical Study Of Photoselective Vaporization Of Porstate (120W) In High Risk Older Patients With Benign Prostatic Hyperplasia

Objective To explore the recent clinical safety and efficacy of photoselectivevaporization of prostate (120W) for the treatment of high risk older patients withbenign prostatic hyperplasia. In this study, the technique of operation also was discussed,and then the complications were prevented and treated.Methods During from January2011to June2011, PVP treatment of78cases ofhigh-risk older patients with benign prostatic hyperplasia were observed. Theobservation target included before and after surgery of symptoms, IPSS, QOL, Qmax,RUV, the time of operation, postoperative bladder irrigating time, the meanpostoperative indwelling catheter time, the level of preoperative and postoperativeserum sodium, the changes of hemoglobin content, the mean postoperative hospitalstay and so on. In addition, the clinical efficacy and complications were analyzed.Results All the operations were smooth. There were not transurethral resectionsyndrome. No cases was dead, and one case was transfusion after operation. Theoperation average time （51.7±17.2） min, the average amount of bleeding (29.4±16.3)ml, postoperative bladder irrigating time was8～78h，the mean was（19.7±6.6）h, the mean postoperative indwelling catheter time （3.4±0.7） d, the mean postoperative hospital stay （4.9±1.6） d. About six months after operation,Postoperative international prostate symptom score was decreased from preoperative（27.8±4.5） scores to（6.1±1.7）scores, quality of life was decreased frompreoperative（5.1±0.5）scores to（1.5±0.7）scores, maximum flow rate was increasedfrom preoperativ（e6.2±1.2）ml/s to（20.7±4.6）ml/s, residual urine volume comparedwith preoperative are significantly improved (P＜0.001) and decreased frompreoperative （87.4±47.7）ml to（20.6±12.9）ml.There was no obvious complications during operation. Postoperative complicationsmainly consisted of bladder spasm, transient dysuria, urinary irritation symptoms,secondary bleeding transient urge incontinence. And then all these complications weresignificantly improved after given symptomatic treatment. There was one case ofdeveloped intractable urine postoperative pain. Consideration this was relation tobladder neck set too deep and postoperative recurrent urinary tract infections, so thepatient was given the treatment of anti-infection, and the pain was improved after thistreatment. According to long-term complications, in this study, we founded thatpostoperative recurrence in1case, the bladder neck stenosis in2cases, urethral stricturein2cases. About postoperative recurrence and the bladder neck stenosis, these patientswere heal after accepted photoselective vaporization of prostate (120W) again. Thepatients with urethral stricture urethra were heal after accepted expansion.Conclusions With the safe operation of photoselective vaporization of prostate(120W) for the treatment of high risk older patients with benign prostatic hyperplasia, itis less bleeding, recent efficacy is significant, and it is especially appropriate to elderlypatients at high risk of large gland. Postoperative follow-up period indices such as IPSS,QOL, Qmax, RUV compared with preoperative obviously improved. The curative effectof PVP (120w) is distinct in the near future, but the forward curative effect remains to be further follow-up. PVP has certain complications, postoperative need to properlyhandle.