Observation On The Therapeutic Effect Of Transurethral Expansion Of Prostate With Columnar Water Sac In The Treatment Of BPH

Objective:To compare the short-peroid effect of transurethral expansion of prostate with columnar water sac(TUSP)and bipolar transurethral plasmakinetic prostatectomy(TUPKP)of treating benign prostatic hyperplasia(BPH),in order to provide clinical surgery choices for reference.Methods:A retrospective analysis was performed in 240 cases of benign prostatic hyperplasia in the Department of Urology Surgery,China-Japan Union Hospital of Jilin University from June 2016 to July2018.Lower urinary tract was the main symptoms,such as frequency of urination,urgency of urination,increased nocturnal urination,hesitation of urination,dysuria,and the patients who have not seen significant improvement after drug treatment or refused medical treatment.Patients included in this study were checked in strict accordance with the criteria for selection or exclusion,and were diagnosed as BHP.According to the different surgical methods,The patients were divided into two groups:120 cases of TUSP 120 cases of TUPKP.There were no significant difference between the two groups(P> 0.05),in the average age and preoperative prostate volume,international prostate symptom score(IPSS),quality of life index score(QOL),maximum urinary flow rate(Qmax),residual urine volume(RU),prostate-specific antigen(PSA),hemoglobin and ionic renalfunction and so on.The operative time,postoperative indwelling time and postoperative hospitalization time of the two groups were recorded and compared.Remaining urine volume(RU),maximum urinary flow rate(Qmax),International Prostate Symptom Scale(IPSS),Quality of Life Index(QOL)and postoperative complications were recorded at 1 and 3months after operation.A questionnaire survey about the effect on sexual function on patients followed up by telephone after operation(only for patients who have sex life).Results : The operation time,indwelling catheter time,hospitalization time and postoperative complication rate of TUSP patients were significantly lower than those of TUPKP patients(P<0.05).The results showed that TUSP patients had shorter operation time and faster recovery after operation,which could significantly reduce the potential risks and postoperative complication rate during operation.However,there were no significant differences in residual urine volume(RU),maximum urinary flow rate(Qmax),International Prostate Symptom Scale(IPSS)and Quality of Life Index(QOL)between the two groups(P > 0.05).The results showed that the short-term clinical efficacy of TUSP patients was satisfactory.In addition,the results of aquestionnaire survey to patients with sexual life showed that the satisfaction of sexual life of TUPKP patients after operation was reduced,and the sexual function of TUSP patients had no significant changecompared with that before operation.Conclusion: TUSP and TUPKP have similar short-term clinical effects in the treatment of benign prostatic hyperplasia.Both of them can improve the symptoms of dysuria and the quality of life in patients with benign prostatic hyperplasia.In general,TUSP has the following advantages.1.It is safe and effective;blunt dilatation only damages part of the urethral mucosa,with less trauma,less bleeding,quick recovery after operation,and its short-term curative effect is no less than other surgical operations.2.The operation is simple,the learning curve is short,and it is easy for primary hospitals to carry out.3.Retain the original organ and sexual function.4.It can be performed under lumbar spinal anesthesia with high safety,and is worthy of clinical application and promotion.