The Application Of Endoscopic Assisted Direct Vision In Transurethral Columnar Balloon Dilation Of The Prostate

Objective:To compare the clinical efficacy and safety of transurethral columnar balloon dilation of the prostate(TUCBDP)and transurethral resection of prostate(TURP)for benign prostatic hyperplasia(BPH).Methods:We adopted a retrospective analysis method.A total of 74 patients with benign prostatic hyperplasia who underwent surgical treatment in the first hospital of shanxi medical university from September 2016 to April 2018 were selected,including 36 patients in TUCBDP group and 38 patients in TURP group.We compared the international prostate symptoms(IPSS)score,quality of life(Qol)score,maximum urine flow rate(Qmax),residual urine volume(PVR),and international erectile function index(iief-5)of the two groups before and after surgery.Operative time,intraoperative blood loss,intraoperative and postoperative complications were also compared.Results:All the operations were completed successfully and none of them were terminated or converted to open surgery.The operative time and intraoperative blood loss in TUCBDP group were significantly less than those in TURP group.Compared with preoperative results,IPSS score,Qol score and Qmax were significantly improved,and PVR were significantly decreased at 6 and 12 months of follow-up between the two groups(p < 0.05).There was no statistically significant difference between the twogroups(p > 0.05).For those BPH patients who still had sexual life,the iief-5 score of TUCBDP group at 12 months after surgery showed no significant change compared with that before surgery,and there was no statistically significant difference(p > 0.05).The iief-5 score of patients in the TURP group decreased significantly 12 months after surgery compared with that before surgery,and the difference was statistically significant(p < 0.05).In addition,a total of 3 patients showed transient incontinence after the removal of urinary catheter,including 1 case in TUCBDP group and 2 cases in TURP group.All of them recovered within 2 weeks after the removal of urinary catheter and no true incontinence occurred.TURS appeared in 2 patients in the TURP group,which improved after diuresis,correction of electrolyte disturbance,and fluid rehydration.One patient in the TURP group underwent secondary hemostasis due to postoperative hemorrhage and was treated with blood transfusion.Conclusion:Endoscopy-assisted direct vision of TUCBDP in the treatment of BPH is effective and safe.In addition,TUCBDP has the advantages of short operation time,less intraoperative blood loss,and less impact on patients' erectile function,especially suitable for elderly patients,patients with more complications or relatively young patients with higher sexual function requirements.