Clinical Study On Risk Factors Of Acute Epididymis-orchitis After Transurethral Enucleation And Resection Of The Prostate

Background : Transurethral enucleation and resection of the prostate(TUERP)is an improved procedure for the treatment of benign prostatic hyperplasia(BPH)obstruction.It is widely used in a wide range of clinical applications.The advantages of high body resection rate and early removal of catheters at the postoperative stage are also well studied at home and abroad for complications such as urinary incontinence,hemorrhage and urethral stricture after TUERP,and for early postoperative acute epididymis-orchitis,clinical Physicians’ attention and related research are relatively few.Once the early postoperative acute epididymis-orchitis occurs,it will lead to a series of adverse consequences such as increasing medical costs and reducing treatment satisfaction.Objective: Retrospective analysis of early acute epididymis-orchitis risk factors after transurethral anatomic prostatectomy,thereby guiding the improvement of TUERP technical route and perioperative diagnosis and treatment,in order to reduce the incidence of early acute epididymis-orchitis after TUERP,saving medical care Cost and improve treatment satisfaction.Materials and methods:Statistics from June 2015 to September 2018 urology patients with transurethral anatomical prostatectomy.According to the early postoperative acute epididymis-orchitis,the patients were divided into the inflamed group and the non-inflammatory group.The perioperative general data and clinical evaluation indexes of the two groups were collected.The measurement data were expressed as mean(?±s)the count data was expressed as rate(%),and the T test and chi-square test were used for comparison between groups.Risk factors for early acute epididymis-orchitis that may lead to postoperative TUERP were included in the logistic regression analysis.P <0.05 was statistically significant and statistically significant.RESULTS: According to the exclusion criteria,470 patients with TURP were enrolled,including 20 patients with acute epididymis-orchitis.According to the inclusion exclusion criteria,a total of 220 patients were included in the study,including 21 patients in the inflammation group and 199 patients in the non-inflammatory group.The incidence of acute epididymis-orchitis in the early stage after TUERP was 10.5%.The mean age of the inflammatory group after TUERP was(67.8±7.5)years,and the mean age of the non-inflammatory group was(70.4±8.1)years old,P=0.161.The differences were not statistically significant and comparable.Hypertensive disease: 3 cases(14%)in the inflammation group,35 cases(17%)in the non-inflammatory group(P=0.467),diabetes mellitus: 7 cases(33%)in the inflammation group,20 cases(10.1%)in the non-inflammatory group P= 0.007;indwelling catheterization>3 days: 6 cases(28%)in the inflammation group,20 cases(10%)in the non-inflammatory group,P=0.012;preoperative leukocytic positive: 9 cases(42%)in the inflammation group,non-inflammation group 30 cases(15%),P=0.006;prostate volume>80m: 8 cases(38%)in the inflammation group,21(10%)in the non-inflammatory group,P=0.002;operation time>90min: 15 cases in the inflammation group(71%)91 patients(45%)in the non-inflammatory group,P=0.025;preoperative I-PSS score: inflammation group(28.01 ± 5.25),non-inflammatory group(27.61 ± 5.1),P=0.72;antibiotic application time: Inflammatory group(48.6 ± 10.6)H,non-inflammatory group(49.3 ± 12.4)H,P=0.804;prostate biopsy before operation: 2 cases(9.5%)in the inflammation group and 25 cases(12.6%)in the non-inflammatory group,P= Preoperative t-PSA:Inflammatory group(7.0 ± 9.6)ng/ml,non-inflammatory group(7.6 ± 7.9)ng/ml,P=0.784;Glandectomy ratio: Inflammation group(47% ± 15%),Non-inflammatory group(45% ± 17%),P = 0.605.Statistical analysis,combined with diabetes,postoperative indwelling catheterization for more than 3 days,preoperative leukocyticpositive,prostate volume greater than 80 ml,and operation time greater than 90 minutes is a risk factor for epididymal-orchitis in the early postoperative period.Other clinical evaluation indicators,such as whether combined with hypertension,preoperative IPSS score,antibiotic application time,preoperative prostate biopsy,preoperative t-PSA,gland resection ratio,P>0.05,no statistical significance.Logistic regression results showed that prostate volume greater than 80 ml and indwelling catheterization greater than 3 days were independent risk factors for early acute epididymis-orchitis after TUERP(P<0.05).There was no significant difference in other related factors(P>0.05).Conclusion:This study found that prostate volume > 80 ml,postoperative indwelling catheterization > 3 days is an independent risk factor for early acute epididymis-orchitis after TUERP.For high-risk patients,the perioperative period of TUERP should be closely observed for the presence of early post-acute epididymis-orchitis signs for early detection and early treatment.The technical route of TUERP should continue to be optimized,individualized treatment,thereby reducing the incidence of acute epididymis-orchitis in patients after surgery and reducing medical costs.