| Objective:the author wishes to explore the clinical efficacy of transurethral thulium laser enucleation of the prostate and resection of the prostate for benign prostatic hyperplasia,and also analyzes if the Thulium laser enucleation of the prostate for benign prostate hyperplasia is safe and effective.Methods:Research objects: 51 cases of BPH patients who were treated in the urology department of the First Hospital of Shanxi Medical University from August 2018 to October 2019 were collected,and the patients were randomly divided into several groups.Urethral thulium laser enucleation of the prostate(ThuLEP)was operated by the experimental group,and the other group underwent traditional transurethral resection of the prostate(TURP).However,all the above operations were performed by the same operator.Observation items: As for two surgeries,the research mainly recorded such elements and also conducted contrast among them,including operation time,glandectomy weight,postoperative hemoglobin reduction value,postoperative urinary indwelling time,postoperative bladder irrigation time,postoperative hospitalization time and surgical complications.Patients in these two groups were followed up regularly for 6 months,and the objective indicators before and after surgery were compared between the two groups: maximum urine flow rate(Qmax),residual urine volume(PVR),and subjective indicators of the International Prostate Symptom Score(IPSS),quality of life index(QoL),assessment of the postoperative improvement.Results:A total of 51 patients were included in the research,26 in the experimental group(ThuLEP)and 25 in the other group(TURP).The general situations of patients in these two groups before surgery(there is no statistical difference(p> 0.05).The maximum urinary flow rate(Qmax),residual urine volume(PVR),subjective indicators of International Prostate Symptom Score(IPSS),There was no difference of quality of life index(QoL)on the stastical level(P> 0.05).The surgeries were successfully completed in both groups,and no complications such as blood transfusion,resection syndrome,and bladder perforation occurred during the operation.All the postoperative pathological results were benign prostatic hyperplasia.Hemoglobin reduction in two groups [ThuLEP group(11 ± 5.3)g / L,TURP group(15.0 ± 4.3)g / L,p <0.05],glandular resection weight [ThuLEP group(34.8 ± 24.7)g,TURP group(27.8 ± 23.5)g,p <0.05].On the statistical level,as for the postoperative urinary indwelling time and length of hospital stay of two groups,ThuLEP group was better than that of the TURP group.[ThuLEP group(2.7 ± 1.5)d,TURP Group(4.0 ± 1.45)d,p <0.05],the comparison of the postoperative hospitalization time [ThuLEP group(4.0 ± 1.0)d,TURP group(4.9 ± 1.0)d,p <0.001],there were differences among the four indicators on the stastical level,and In particular,as for the length of postoperative hospital stay,which was of great difference of the two groups(p <0.001).The ThuLEP group took longer than the TURP group during the operation,[ThuLEP group(100.0 ± 35.8)min,TURP group(70.6 ± 19.3)min,p <0.001].The results showed that the data of the two groups were statistically different.considering that the glandular tissues need to be obtained by using a tissue pulverizer after enucleation to push the glands into the bladder,we counted the time(77.8 ± 25.8)minutes of laser use in the ThuLEP group,which meant that there were no differences of Tissue shredding between two groups.Two patient in the TURP group felt better after symptomatic anti-infective treatment of urinary tract infection after surgery.One patient in the TURP group developed symptom,that was acute urinary retention after removal of the urinary tract,and then get relieved after reinsertion.Some patients of both groups had acute transient urinary incontinence(1 in the TURP group and 2 in the ThuLEP group),and both have recovered after guided exercise.Patients in both groups were regularly followed-up.The maximum urine flow rate(Qmax),residual urine volume(PVR),subjective indicators of international prostate symptom score(IPSS)and quality of life index(QoL)in each groups were compared with those before the surgery.There were significant differences among them(p <0.05),but there was no difference between two groups in the same period(p> 0.05).Conclusion:Transurethral thulium laser enucleation is a safe,effective treatment for Benign Prostatic Hyperplasia,and its short-term efficacy is comparable to transurethral resection of the prostate.Compared with transurethral resection of the prostate,it performs better in controlling intraoperative bleeding,increasing the rate of proliferative tissue resection,and shortening the urinary indwelling time and length of hospital stay.Meanwhile,it has unique advantage especially for large-volume prostate hyperplasia,and it can also be seen as the ideal treatment for Benign Prostatic Hyperplasia. |
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