Clinical Study On 2?m Continuous-wave Laser Enucleation Of The Prostate

ObjectiveTo compare the safety and efficacy of RevoLix 120 W 2?m continuous-wave laser enucleation of the prostate(ThuLEP)with plasmakinetic resection of prostate(PKRP)in patients with symptomatic benign prostatic hyperplasia.To evaluate the effects of ThuLEP and PKRP on sexual function.MethodsAll 308 patients with BPH underwent ThuLEP(n=156)or PKRP(n=152)between June 2014 and June 2016.The operative time,drop in hemoglobin,hospital stay,irrigated volume,indwelling catheterization time and operative complications were recorded.All patients were followed up for 12 months.In preoperative and postoperative 1,6,12 months International prostate symptom score(IPSS),quality of life(QoL),urinary peak flow rate(Qmax)and post-voiding residual urine(PVR)were also compared.Preoperative and postoperative 12 months using the International Index of Erectile Function(IIEF)score and self-designed ejaculation function questionnaire to evaluate the patient's sexual function.ResultsCompared with PKRP,ThuLEP required longer operation time(65.4 vs 47.4 min,p<0.05)but resulted in less hemoglobin decrease(1.5vs3.0g/L,p<0.05),catheterization time(2.1vs3.5 days,p<0.05),irrigated volume(12.4 vs 27.2 L,p<0.05),and hospital stay(2.5 vs 4.6 days,p<0.05).During the 12-month follow-up,ThuLEP and PKRP can significantly improve the patient's Qmax and reduce the IPSS,QoL and PVR(p<0.05).Bo procedures demonstrated no significant difference in terms of Qmax,IPSS,PVR urine volume,and QoL(p>0.05).The IIEF scores difference was no significant before treatment between two groups(p>0.05).In two groups,there Was no significant difference in erectile function,sexual desire,sexual satisfaction and overall satisfaction score between before treatment and 12 months after treatment(p>0.05),orgasm score 12 months after treatment was significantly lower than that before treatment[ThuLEP group:(5.9±1.5)scores vs(8.6±2.7)scores;PKRP group:(5.5±1.6)scores vs(8.7±1.8)scores ](p<0.05).Multiple linear regression analysis showed that two groups EF score and IPSS,QoL and Qmax positive linear correlation.Logistic regression analysis showed that the incidence of retrograde ejaculation and orgasm reduced significantly associated(p<0.05),as all independent predictor of orgasm reduced after treatment(p<0.05).ConclusionsThuLEP was statistically superior to PKRP in blood loss,catheterization time,irrigated volume,and hospital stay but inferior to PKRP in operation time.During the 12-month follow-up,ThuLEP and PKRP can significantly improve the patient's Qmax and reduce the patient's IPSS,QoL and PVR.However,both procedures showed no significant difference in terms of Qmax,IPSS,PVR,and Qo LS.There is no difference between these two surgical techniques regarding to impact on sex function.No significant erectile function improvement after surgery in both groups,but these two techniques can significantly decrease the IIEF orgasmic function domain and this is mainly caused by retrograde ejaculation.