A Comparative Study Of 1470nm-laser Enucleation Of The Prostate And Transurethral Plasmakinetic Prostatectomy

Purpose:To compare 1470nm-laser enucleation of the prostate(LEP)and transurethral plasmakinetic prostatectomy(TUPKP),and try to explore the efficacy and safety of treating benign prostatic hyperplasia in order to provide clinical surgery choices for reference.Methods:Retrospective analysis is given on basis of 53 patients with benign prostatic hyperplasia(BPH)hospitalized during the period from Janurary2015 to September 2016 in the China–Japan Union Hospital of JILIN University.The causes for medical treatments are mainly the low urinary tract symptom such as progressive dysuria,urinary frequency and urgency,excessive urination at night and so on,and through certain medical treatments,they have no obvious improvements,or refuse drug therapy,or have related complications.Various examinations and the postoperative pathology are done to confirm for the benign prostatic hyperplasia,ruling out the patients with previous BPH surgeries,incorporation neurogenic bladder,urethrostenosis,bladder tumor and other diseases.The age span is between 60 and 84,with an average of71.1±6.8 years old.The disease duration ranged from 3 to 10 years,and the mean disease course is 6.0±2.2 years.According to the operation method,the patients are divided into two groups.Group LEP: 23 caseswith 1470nm-laser enucleation of the prostate;Group TUPKP: 30 cases with transurethral plasmakinetic prostatectomy.Compare the statistics of the two groups in ages,preoperative prostate volume,prostate specific antigen(PSA),the international prostate symptom score(IPSS),quality of life(QOL),maximum Quantity of urinary flow(Qmax),post-void residual volume(PVR),indicators of hemoglobin and serum sodium levels;Operation time,postoperative hemoglobin,serum sodium values,bladder douche time,catheter retention time and hospitalization time;at 1 and 6 months after surgery,the Operative complications,the international prostate symptom score(IPSS),quality of life(QOL),maximum Quantity of urinary flow(Qmax),and post-void residual volume(PVR)as indicators.Results:All the 53 cases of BPH operations in the study have been successfully completed.1.As to the comparison between Group LEP and Group TUPKP in the ages,preoperative prostate volume,PSA,IPSS,QOL,Qmax,PVR,hemoglobin and serum sodium levels,the differences were not statistically significant(P>0.05).2.Compared to Group TUPKP,Group LEP has higher postoperative hemoglobin,but shorter bladder douche time,catheter retention time and hospitalization time.The differences have statistical significance(p <0.01,p < 0.01);there was no statistically significant difference in postoperative serum sodium levels of the two groups(P > 0.05).However,Group LEP has longer operation time than Group TUPKP,and the difference is statistically significant(p < 0.01).3.After 1 month and 6 months follow-up,IPSS,QOL,Qmax and PVR of both groups are markedly improved,and the difference has statistical significance(p < 0.01).But there is no statistically significant difference between two groups(P > 0.05).4.In terms of complications,the incidence of Group LEP is 8.7%(2/23)while that of Group TUPKP is 13.3%(4/30).There was no statistically significant difference between the two groups(p > 0.05).Conclusion:1.TUPKP and LEP in the treatment of benign prostatic hyperplasia,with similar efficacy,can significantly improve urination situation of patients;2.Although intraoperative time of LEP is longer than TUPKP's,it,having the advantages of less intraoperative bleeding and postoperative recovery faster,together with the same and total incidence of complications in both,is worthy of clinical application.