| BackgroundBenign prostatic hyperplasia(BPH)is one of the common diseases in middle-aged and elderly men.With the increase of age,the incidence rate gradually increases,and patients with urinary dysuria symptoms often need surgery.Transurethral resection of the prostate(TURP)has been recognized as the gold standard for the treatment of benign prostatic hyperplasia,but there are complications such as bleeding,TUR syndrome,urinary incontinence,and retrograde ejaculation.And the large prostate also limits the application of TURP.In recent years,with the rapid development of laser technology,laser has become more and more widely used in urology.Neodymium laser,holmium laser,greenlight laser,thulium laser,and 1470nm semiconductor laser have shown more and more advantages in the treatment of BPH.Laser enucleation of the prostate is currently the most widely used procedure in the treatment of benign prostatic hyperplasia.However,for the treatment of prostate glands after laser enucleation,the methods used are inconsistent.At present,transurethral morcellation of the gland surgery is commonly used in various centers,and our center adopts suprapubic cystostomy morcellation of the gland.This study retrospectively analyzed 120 cases of BPH patients treated with suprapubic cystostomy morcellation of the gland and transurethral morcellation of the gland after 1470nm semiconductor laser enucleation of the prostate.The difference between these two methods were comparedObjectiveTo compare thesafety and efficacy of the two surgical approaches,suprapubic cystostomy morcellation of the gland versus transurethral morcellation of the gland,in the treatment of benign prostatic hyperplasia(BPH).MethodsFrom August 2017 to February 2019,120 cases of BPH were enrolled,and they were divided into two groups according to the surgical procedure:60 cases in group A were underwent suprapubic cystostomy morcellation of the gland,60 cases ingroup B were treated by transurethral morcellation of the gland.The time of gland enucleation,the time of gland morcellation,the operative time,the weight of gland resection,the efficiency ofgland morcellation,duration of postoperative bladder irrigation,indwelling catheterization time,hospital stay time and the postoperative complications were recorded.The International Prostate Symptoms Score(IPSS),Quality of life(QOL),post-voiding Residual urine(PVR),maximum urine flow rate(Qmax)were also compared.ResultsPatients in the group A displayed shorter gland morcellation time[(4.5±0.8)min vs(10.5±2.6)min,P<0.05)],higher efficiency of gland morcellation[(10.2±3.1)g/min vs(4.3±1.2)g/min,(P<0.05)],shorteroperative time[(62.3±13.8)min vs(68.81±14.9)min,(P<0.05)],While the time of gland enucleation[(57.8±16.3)min vs(58.3 ± 17.4)min],the weight of gland resection[(45.6 ± 14.3)g vs(44.8 ± 13.6)g],duration of postoperative bladder irrigation[(2.0±0.5)d vs(2.1±0.6)d],indwelling catheterization time[(2.4±0.3)d vs(2.5±0.4)d]and average hospital stay time[(7.8±1.3)d vs(7.6±1.4)d]were no significant differences between the two groups(P>0.05).4 cases in group B occurred bladder injurywhile none in the group A,The incontinence presented in both groups(3 in the group B and 1 in the group A),but all recovered within 1-3 months,Perioperative complications were more less in the group A(P<0.05).The IPSS,QOL,PVR and Qmax were significantly improved after 3 months postoperatively in both groups,but there were no significant differences between the two groups(P>0.05).ConclusionThe suprapubic cystostomy morcellation of the gland is an excellent treatment for BPH as well as transurethral morcellation of the gland,and has the advantage of significantly shorter gland morcellation time,shorter operative time,higher efficiency of gland morcellation and lower incidence of complications. |
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