Clinical Analysis Of Two Kinds Of Enucleation For Benign Prostatic Hyperplasia

Objective: To analyze the clinical effect of transurethral plasmakinetic enucleation of prostate(PKEP)and transurethral holmium laser enucleation of the prostate(HoLEP)in the treatment of Benign prostatic hyperplasia.Methods: A retrospective analysis was made on 70 patients with BPH treated in the Department of Urology,affiliated this Hospital from June 2013 to March 2020.According to the condition and the wishes of the patients,32 patients were treated with HoLEP(HoLEP group)and 38 patients were treated with PKEP(PKEP group).The preoperative,intraoperative and postoperative clinical data were collected,including age,prostate volume,IPSS score before and 6 months after operation,QOL score,Qmax,enucleation time,postoperative hemoglobin decrease,bladder irrigation time,catheter indwelling time,hospital stay,operation cost,intraoperative and postoperative complications,etc.,and the safety and short-term postoperative efficacy of the two methods were compared.Results:(1)There were no statistically differences in preoperative IPSS score,QOL score,Qmax,age and prostate between the two groups(P>0.05).There was no statistical difference in hemoglobin decline between the two groups,HoLEP Group vs PKEP group(16.81±5.64 vs 15.76±5.18 g/l,P>0.05).(2)The preoperative IPSS,QOL and Qmax of HoLEP group were 20.53 ±2.53,5.00(5.00-5.00)and 8.00(7.00-8.00),respectively.Six months after operation,it was7.19±0.78,1.00(0.25-1.00)and 18.00(17.00-19.00)respectively,which was significantly better than that before operation(P<0.001).The preoperative IPSS,QOL and Qmax in the),PKEP group were 20.11±2.31,5.00(5.00-6.00)and 7.50(7.00-8.00),respectively.Six months after operation,it was 7.45±0.80,1.00(0.00-1.00)and 18.00(17.00-20.00)respectively,which was significantly better than that before operation(P<0.001),but there was no statistically difference in IPSS,QOL and Qmax between the two groups(P>0.05).The time of enucleation in HOLEP group was longer than that in PKEP group(46.09± 7.86 vs 42.11 ± 7.79)min,with statistically difference(P<0.05).(3)Complications in HoLEP group were 6 cases,3 cases(9.38%)with transient urinary incontinence,2 cases(6.25%)with bladder spasm,1 case(3.13%)with urethral stricture,Complications in PKEP group were 7 cases,2 cases(5.27%)with transient urinary incontinence,3 cases(7.89%)with bladder spasm and 1 case(2.63%)with urethral stricture,perforation of prostatic capsule in 1 case(2.63%).In HoLEP Group and PKEP group,the time of bladder irrigation,indwelling catheter and hospitalization were(19.19±1.51 vs 15.55±1.78)h,(3.19±0.64 vs 3.18±0.61)d,(4.31±0.99 vs 4.26±0.89)D,respectively,however,there was no statistical difference in complications,bladder irrigation time,indwelling time and hospitalization time between the two groups(P>0.05).(4)The cost of operation in HoLEP group was significantly higher than that in PKEP group(11513.97±74.34 vs 5804.6±13.66),there was statistically significant difference(P< 0.001).Conclusion:The clinical efficacy and safety of the two methods in the treatment of BPH are accurate and safe,and there is no significant difference in the short-term postoperative effect,but the PKEP group has more advantages in terms of operation time and cost.