| Objective:To compare the incidence and degree of urinary incontinence after transurethral plasmakinetic enucleation of prostate(TUPKEP)for benign prostatic hyperplasia(BPH)by conventional and improved methods,and to verify and analyze the effect of improved TUPKEP on improving postoperative urinary incontinence.Methods:The clinical data of 60 patients with benign prostatic hyperplasia who underwent transurethral plasmakinetic enucleation of prostate in the urology department of Bengbu Second People’s Hospital from March 2017 to July 2018 were retrospectively analyzed,including 25 patients in the conventional TUPKEP group and 35 patients in the modified TUPKEP group.The operation time,prostate tissue volume,intraoperative blood loss,postoperative bladder irrigation time,postoperative indwelling catheter time,postoperative hospitalization time and complications of the two groups were recorded.At the same time,the International Prostate Symptom Score(IPSS),Quality of Life Score(QOL),residual urine volume and urinary incontinence 24 hours,1 week,2 weeks,1 month and 3 months after catheter removal were recorded in the two groups.The recorded clinical data of the two groups of patients were statistically analyzed and concluded.Results:There was no significant difference between the two gr oups in preoperative general data,age,IPSS score,QOL score,prostate volume detected by B-ultrasound,residual urine volume,prostate specific antigen and complications(P>0.05).There was no significant difference between the two groups in operation ti me,weight of prostate tissue removed,amount of bleeding durin g operation,bladder irrigation time after operation,indwelling cat heter time after operation,hospitalization time after operation an d other operation related indexes(P>0.05).The two groups of p atients successfully completed the operation,without transferring to open operation,without blood transfusion during or after the operation,without cases requiring emergency treatment during or after the operation,and without bladder perforation or rectal pe rforation during the operation.Postoperative pathological results were all benign prostatic hyperplasia.IPSS score,QOL score an d residual urine volume at 1 month and 3 months after operatio n in the two groups were significantly improved compared with those before operation,and the difference was statistically signifi cant(P<0.05).There was no significant difference in IPSS score,QOL score and residual urine volume between the two groups 1 month and 3 months after operation(P>0.05).The incidence o f urinary incontinence 24 hours after catheter removal in the mo dified TUPKEP group was lower than that in the conventional T UPKEP group,with statistically significant difference(P<0.05),T he incidence of urinary incontinence in the modified TUPKEP gr oup was also lower than that in the conventional TUPKEP grou p one week and two weeks after catheter removal,no urinary in continence occurred in the modified TUPKEP group one month after catheter removal,and there was one case of urinary inconti nence in the conventional TUPKEP group.no urinary incontinen ce occurred in the two groups three months after catheter remov al,but the difference was not statistically significant(P>0.05).F or patients with urinary incontinence 24 hours after catheter rem oval,the leakage of urine in the improved TUPKEP group was lower than that in the conventional TUPKEP group,with statistic al significance(P<0.05),but there was no statistical significance in the leakage of urine in the urinary incontinence patients one week after catheter removal between the two groups(P>0.05).T here was no secondary hemorrhage after operation in both group s,and the incidence of bladder neck contracture and urethral stri cture was not statistically significant between the two groups(P>0.05).Conclusion:Modified TUPKEP has the same safety and efficacy as conventional TUPKEP.Compared with conventional TUPKE P,modified TUPKEP has lower incidence of early postoperative urinary incontinence and lower degree of urinary incontinence. |
PDF Full Text Request