Comparison Of The Effects Of DiLEP And PKRP On Postoperative Urinary Control And Sexual Function In Patients With Large-volume Benign Prostatic Hyperplasia

Objective:To investigate the effect of DiLEP(1470nm diode laser enucleation of the prostate,DiLEP)compared with PKRP(Plasmakinetic resection of the prostate,PKRP)on postoperative sexual function in patients with large-volume benign prostatic hyperplasia(prostate volume >80 ml),and to provide a reference for the promotion of 1470 nm diode laser technology in clinical practice.Methods:In our study,155 patients who underwent DiLEP(95 cases)versus PKRP(60 cases)respectively for large-volume prostatic hyperplasia in the Department of Urology,The First Affiliated Hospital of University of South China,from August 2018 to September 2020,were selected for retrospective analysis,and the procedures were performed by the same experienced and skilled Dil EP and PKRP.In the observation group(95)patients were treated with DiLEP for large-volume prostatic hyperplasia and in the control group(60)patients were treated with PKRP for large-volume prostatic hyperplasia.The preoperative general data included age,BMI,hypertension comorbidity,post-void residual volume(PVR),length of medical history,duration of oral finasteride,IPSS(international prostate symptom score),QOL(quality of life score),IIEF-5(international index of erectile function),EHS,PV(Prostatic volume),Qmax(maximum flow rate),occurrence of preoperative urinary retention,total prostate specific antigen(t PSA)and preoperative sexual intention were not statistically significant(P>0.05);postoperative time of surgery was recorded,and follow-up was performed at about 3 months after surgery to record relevant indicators,including: follow-up time,urinary control indicators: IPSS,QOL,Qmax,t PSA.Sexual function indexes: IIEF-5,EHS,retrograde ejaculation rate,ejaculatory pain incidence,hemospermia incidence,and postoperative sexual willingness.Statistical analysis was performed on them.Results:1.Preoperative general information(age,BMI,hypertension comorbidity,post-void residual volume(PVR),length of medical history,duration of oral finasteride,IPSS,QOL,IIEF-5,EHS,PV,Qmax,occurrence of preoperative urinary retention,total prostate specific antigen(t PSA)and preoperative sexual intention)were not statistically significant(P>0.05).2.Postoperatively,Qmax,QOL,and t PSA of patients in both groups showed significant improvement compared with those before surgery,and the differences were statistically significant(P<0.05),After surgery,there was no statistically significant difference between the two groups(P> 0.05).3.Compared to the preoperative period,the postoperative IPSS improved significantly in both groups,with the difference reaching a significant level(P<0.05),and the DiLEP group showed a greater improvement in IPSS,with a significant difference between the two groups after surgery(P<0.05).4.There was no significant difference in the duration of surgery between the two groups(P>0.05);there was no significant difference in the length of postoperative follow-up between the two groups(P>0.05);the IIEF-5 score decreased in both groups after surgery,with a significant difference(P<0.05),and the IIEF-5 score decreased more in the PKRP group after surgery,with a significant difference between the two groups(P<0.05);after surgery There was no significant difference in the EHS rating between the DiLEP group and the preoperative group(P>0.05),while the EHS rating in the PKRP group decreased after surgery,with a significant difference(P<0.05)and a significant difference between the two groups(P<0.05);there was no significant difference between the two groups in the incidence of retrograde ejaculation,painful ejaculation and haemorrhage after surgery(P>0.05);after surgery There was no significant difference between the two groups(P>0.05).Conclusion:1.Both DiLEP and PKRP significantly improved the patients’ postoperative urinary control function,with DiLEP having a better effect on the patients’ urinary control function.2.Transurethral prostate surgery can all have varying degrees of damage to sexual function,but Dil EP has relatively little damage to sexual function,i.e.less impact on sexual function than PKRP,and is a good option for patients with large-volume benign prostatic hyperplasia who have a need for sexual function.