The Observation Of The Recently Efficacy And Safety Of Transurethral Split Of The Prostate For The Treatment Of Benign Prostafic Hyperplasia

In recent years,a number of independent intellectual property rights,reliable efficacy BPH surgical methods are emerging,is at home and abroad to promote the application,challenging BPH "gold standard" surgical.Such as prostate plasma enucleation,buttons electrode plasma vaporization enucleation,etc;especially reserved prostate tissue innovation surgery,such as the remaining portion of the urethra of the front wall of the prostate plasma enucleation,transurethral columnar water sac prostate widened surgery(Transurethral Split of the Prostate,TUSP)and other surgical procedures,and even subvert the traditional concept.TUSP After nearly 20 years of continuous exploration,improve and perfect the formation of the current relatively fixed surgery.Although this type of surgery has completely retained prostate tissue,more simple,less time-consuming operation,the advantages of faster postoperative recovery,but less authoritative literature,the industry also has the Voice of challenge,therefore,further observation,summarize and verify TUSP the efficacy and safety is particularly important.In view of this,in June 2015-March 2016,we used this surgical treatment of 141 patients with BPH,retrospective study aims to objectively evaluate the clinical efficacy TUSP,safety,and surgical in BPH value surgical treatment system.Objective: To evaluate the safety and effectiveness of ransurethral Split of the Prostate to treat benign prostatic hyperplasia(Benign prostatic hyperplasia,BPH),in order to evaluate transurethral Split of the Prostate surgery crack spread value in the treatment of prostate surgery.Methods: Retrospective analysis of June 2015-March 2016,transurethral columnar water sac prostate surgery widened Treatment indications clearly show no absolute contraindications to surgery in patients with benign prostatic hyperplasia 141 cases,including 102 cases in our hospital,outside the hospital 39 cases.Patients aged 46 to 92 years,mean age(69 ± 9.7)years,duration of 3 months to 15 years.By observing the patients before and after surgery urination case,the recording operation time,indwelling catheter time,postoperative complications,and the analysis and comparison of preoperative and postoperative extubation 1-3 days,after one month,after three monthly,residual urine volume(postvoid residual urine,PVR)after six months,maximum flow rate(maximum flow rate,Qmax),international prostate symptom Scale(Intenational prostate symptom score,IPSS)and quality of life score(Quality of life,QOL)and other data to objectively evaluate TUSP term clinical efficacy and safety(long-term clinical efficacy is still under observation).Result:1.The operative time 13~ 45 min,an average of(15.9±7.7)min,after conventional catheterization seven days.All patients undergoing successful.2.There were no deaths.3.The short-term postoperative pseudo-incontinence,urge incontinence in 11 cases,month after spontaneous remission.There were no cases of incontinence.4.5 cases of postoperative bleeding(bleeding 1000-2000ml).3 cases of conservative treatment.The other 2 patients because of repeated bleeding,respectively,after 7 days,21 days to clear the line of blood clots after surgery recovery.5.The day after extubation acute urinary retention occurred in 15 cases,10 cases were in the catheterization again 5-10 days after the return to normal voiding.4 cases of urinary retention after the line spread open surgery,2 cases of postoperative voiding the other two cases were still difficult urination extubation,then diverted to transurethral resection and postoperative voiding.One patient after recurrent urinary retention diverted suprapubic puncture gastrostomy.6.After the third month of follow-up,10 patients had urinary dribbling,voiding difficulty and other symptoms.5 cases and two cases of elderly patients with chronic prostatitis patients taking Proscar,Harold,and other related drugs,symptoms;the first two cases with urethral stricture,urethral stricture dilation improved after a regular basis 3-5 times.One patient after taking the drugs,no significant improvement,then in the first four months of transurethral resection of the prostate urination.After six months of follow-up,10 patients above private prosecution urination.7.2 cases combined cerebellar atrophy,intraoperative parallel suprapubic ostomy;1 case of postoperative voiding rely bladder fistula,and 1 to urinate,but somewhat laborious.8.The amount of residual urine before surgery(267± 143.8)ml,extubation the same day,after a month,after three months,six months after the residual urine volume was(48±29.3)ml?(56±38.3)ml?(53±36.1)ml?(62±39.4)ml.9.Preoperative maximum urinary flow rate(9.9 ± 4.8)ml / s,pull catheter 1-3 days,after one month,after three months,the maximum flow rate after six months was(23.7 ± 8.5)ml / s,(24.1 ± 8.5)ml / s,(25.6 ± 8.5)ml / s,(26.5 ± 7.8)ml / s.10.Preoperative IPSS was(23 ± 5.7),pull the catheter 1-3 days,after one month,after three months,six months after the IPSS score was(6 ± 4.6),(4.8 ± 4.3),(3 ± 2.8),(2 ± 1.9)11.Preoperative quality of life score was(4 ± 0.8),pull the catheter 1-3 days,after one month,after three months,after six months of QOL scores were(2 ± 1),(1.8 ± 0.8),(1.5 ± 0.6),(1.4 ± 0.5).The test data collected all the mean standard deviation(S)in the form included in the statistical tables,two sets of data were compared using two sample paired t test using SPSS17.0 software were significantly different compared(P <0.05).Conclusions: Transurethral columnar water sac prostate widened the effect of the treatment of benign prostatic hyperplasia sure,simple operation,less bleeding,faster recovery,urinary symptoms improved significantly,etc.,is worthy of promotion and application of minimally invasive therapies.