Different Operation Time Of Treatment Of Large Volume Benign Prostatic Hyperplasia Clinical Comparative Study

Objective: Discussion of large volume benign prostatic hyperplasia(BPH) in patients with the optimal timing of surgery, reduce complications of BPH patients, postoperative effect ideal, protect renal function, improve the quality of life in patients with BPH.Methods:Use prospective controlled study, selection of September 2012- August 2014 in yan 'an university hospital urology clinic, prostate volume more than 60 ml, or TURP surgery of 142 cases of BPH patients, including 7 patients were lost to follow-up for other reasons, the remaining 135 cases, the average age(68.56 + 8.97), the average volume of the prostate(80.61 + 15.66) for ml, B ultrasonic of abdomen, according to prompt patients with bladder wall mucous membrane is normal or not smooth in group A for compensatory prophase, 33 cases; Abdominal ultrasound suggesting the bladder wall thickening, coarse patients in group B late for compensatory, 40 cases; Abdominal ultrasound has little room of the bladder, trabecular and diverticulum formation of patients in group C for decompensated upfront, 32 cases; Abdominal ultrasound tip with acute urinary retention or kidney seeper or renal damage in patients with late in group D for decompensation, 30 cases. Four groups of patients were treated with TURP surgery. Is four groups of cases, volume age, preoperative PVR, Qmax, IPSS, and four groups of cases, respectively, in postoperative 1 month, 3 months follow-up observation, comparison of PVR, Qmax, IPSS.Results:Four groups of age, volume, preoperative PVR(ml), Qmax(ml/s), IPSS(points) : the age, the age of group A(60.60-3.05) and group B(65.08 + 4.87) years, and group C(73.19-6.67), D(77.60 + 8.66) years, each group compare, the difference was statistically significant(P < 0.05). Volume, ml(65.52 + 4.80) of group A, group B(75.33 + 6.32) for ml, ml(85.13 + 7.54) group C, group D(99.93 + 16.32) for ml, groups of mutual comparison, the difference was statistically significant(P < 0.05). Preoperative PVR, ml(46.30 + 6.25) of group A and group B(79.80 + 13.97) for ml, ml(147.68 + 27.74) group C, group D(303.93 + 95.07) for ml, groups of mutual comparison, the difference was statistically significant(P < 0.05). Preoperative Qmax(ml/s),(8.85 + /-2.09 ml/s group A and group B(5.02 + /- 1.49 ml/s and C group(4.00 + /- 1.08 ml/s, D group(2.73 + /- 1.36 ml/s, groups of mutual comparison, the difference was statistically significant(P < 0.05). Preoperative IPSS(points),(13.13-2.07) points in group A and group B(20.23 + 3.92) points, group C(22.97-2.93), group D(27.53 3.83 mm), each group compare, the difference was statistically significant(P < 0.05).Four groups of cases of postoperative 1 month when PVR, ml(31.03 + 7.43) of group A, group B(47.93 + 12.22) for ml, ml(75.88 + 13.56) group C, group D(94.23 + 15.71) for ml, any two two comparison, the difference had statistical significance(P < 0.001). After 1 month of Qmax(ml/s),(11.45 + /- 2.08 ml/s group A and group B(10.35 + /- 2.12 ml/s and C group(9.34 + /- 1.72 ml/s, D group(8.80 + /- 1.77 ml/s, any two two compared, group A, B, C, D group, there was no statistically significant difference(P > 0.001); The difference had statistical significance(P < 0.001). After 1 month of IPSS, group A(5.27-2.94) and group B(8.28 + 2.70) points, group C(10.94-1.74), group D(19.63-4.44) points, any two two compared, the difference had statistical significance(P < 0.001).Four groups of cases of postoperative 3 months PVR, ml(14.97 + 6.54) of group A, group B(31.85 + 11.56) for ml, ml(37.63 + 8.47) group C, group D(47.13 + 15.65) for ml, any two two compared, B and C group, group B, D, C, D group, there were no statistically significant difference(P > 0.001); The difference had statistical significance(P < 0.001). After 3 months of Qmax(ml/s),(13.79 + /- 2.52 ml/s group A and group B(11.80 + /- 1.59 ml/s and C group(11.50 + /- 1.87 ml/s, D group(9.70 + /- 1.74 ml/s, any two two compared, A and B groups, group A, C, B and C group, there were no statistically significant difference(P > 0.001); The difference had statistical significance(P < 0.001). Four groups of cases of postoperative 3 months IPSS, group A(3.61-2.12) and group B(3.93 + 1.93) points, group C(8.53-2.14), group D(12.30-3.66) points, any two two compared, had statistical significance(P < 0.001). Conclusion:1. Large volume BPH patients, prostate volume less than ml(65.52 + 4.80), and bladder wall mucous membrane is normal or not smooth in the early stage of the compensatory, surgical treatment with less postoperative complications, better quality of life.2. Abdominal ultrasound preoperative examination, in the event of a bladder morphological change early surgery may be the optimal timing of surgery for the treatment of large volume BPH patients. 3. The preoperative bladder wall of shape can be used as judgment, large volume BPH patients' operation time is an important reference for indications, can be widely applied in preoperative assessment of surgical treatment of large volume BPH patients.