Clinical Application Of 1470 Nm Semiconductor Laserin Patients With High Risk Of BPH

Objective:To evaluate the safety and effectiveness of diode laser technology(DiLEP)in patients with high-risk benign prostatic hyperplasia(BPH),and to provide reference for the promotion and application of diode laser technology in clinical.Methods:In this study,139 high-risk BPH patients who had DiLEP(75 cases)and PKRP(64 cases)were analyzed retrospectively.All patients were admitted to our group from October 2017 to October 2019.The IPSS symptom scores of patients were ? 8 points.The medical treatment effect was not good or refused medical treatment,or there were related complications,reaching a clear surgical guideline.All patients were over 70 years old(between 70-90 years old)with one or more of the following high-risk factors,including local high-risk factors: massive prostate(prostate volume > 80ml),BPH recurrence,urinary tract infection,hydronephrosis with renal failure,urinary catheter or bladder stone,bladder tumor,inguinal hernia;total height risk factors include: primary Hypertension,arrhythmia,heart failure,diabetes,abnormal coagulation,coronary heart disease,cerebral infarction,chronic obstructive pulmonary disease,pulmonary insufficiency,anemia.All operations were performed by the same surgeon(senior chief physician).We collected preoperative general indexes(age,prostate volume,PSA,IPSS,QOL,Qmax,PVR,Hb,blood sodium value,blood pressure value),preoperative high-risk factors,intraoperative indexes(operation time),postoperative indexes(Hb,blood sodium value,catheter retention time,bladder flushing time,postoperative hospital stay time,postoperative complications)and postoperative follow-up indexes(IPSS?QOL?Qmax?PVR),and make statistics and analysis.Result:1.The two groups of high-risk BPH patients had the same quality(P > 0.05)in the preoperative general indicators(age,prostate volume,preoperative PSA,IPSS,QOL,Qmax,PVR,preoperative hemoglobin and blood sodium value,preoperative systolic and diastolic blood pressure)and preoperative high-risk factors.2.There was no significant difference in operative time between the two groups(P > 0.05),and there was no significant difference in blood sodium value(P > 0.05).3.The postoperative HB value of DiLEP group was significantly higher than that of PKRP group(P < 0.05);the postoperative bladder flushing time,indwelling catheter time and postoperative hospital stay time of DiLEP group were significantly shorter than those of PKRP group(P < 0.01).4.The three-month follow-up indexes(IPSS,QOL,Qmax and PVR)of the two groups were significantly improved(P < 0.01),and there was no significant difference between the two groups(P > 0.05).5.The incidence of postoperative complications and secondary bleeding in the DiLEP group was significantly lower than that in the PKRP group(P < 0.05),but there was no significant difference in other postoperative complications(including temporary urinary incontinence,urinary tract infection,urethral stricture,and postoperative bleeding of bladder neck contracture)(P > 0.05).Conclusion: 1.Semiconductor laser technology and plasma bipolar technology have the same efficiency in vaporizing and cutting prostate tissue,and can effectively improve the lower urinary tract symptoms of patients with high-risk BPH.2.The hemostasis effect of semiconductor laser technology is better than that of plasma bipolar technology,and it has better safety in the treatment of high-risk BPH patients.3.In the treatment of BPH patients with high risk,semiconductor laser technology has better efficacy and safety than plasma bipolar technology.