Clinical Effect Of HoLEP In The Treatment Of Benign Prostatic Hyperplasia Patients With Detrusor Dysfunction

Objective: To evaluate the clinical effect of holmium laser enucleation of prostate(Ho LEP)in the treatment of benign prostatic hyperplasia(BPH)with detrusor dysfunction.Methods: 116 patients with benign prostatic hyperplasia(BPH)who were admitted to our hospital from 2016 to 2020 and treated with Ho LEP were retrospectively analyzed.According to the preoperative bladder detrusor contractility,they were divided into three groups: 50 patients with normal bladder detrusor contractility,38 patients with low bladder detrusor contractility and 38 patients with weak bladder detrusor contractility All the patients in the three groups underwent Ho LEP.Before the operation,the patients filled in IPSS and QOL scores.The urodynamic examination was performed routinely Urinary ultrasound was used to evaluate the tolerance of preoperative operation.Telephone follow-up was conducted 6 months after operation.The follow-up contents were IPSS and QOL scores.The clinical effect was judged to be effective if the IPSS score decreased by more than 50% compared with the baseline and the patient could urinate by himself after removing the catheter.Results: 1.In terms of surgical complications,the operation was successfully completed,including 1 case of secondary bleeding in the normal group,1 case of secondary bleeding and 1 case of urinary tract infection in the weakened group;1 case of secondary bleeding in the non contractive group;2.In terms of the effective rate of operation,the overall effective rate of operation was 93.10%,of which the effective rate of operation in the normal group was 100%(50 / 50)The effective rate was97.37%(37 / 38)in the weakening group and 75.00%(21 / 28)in the non contraction group.3.IPSS and QOL of the normal group were(4.56 ± 0.91)and(1.02 ± 0.38)respectively 6 months after operation,The postoperative residual urine and Qmax were(14.14 ± 3.59)ml and(15.91 ± 4.44)ml / s,respectively.The IPSS and QOL were(6.47 ± 1.70)and(1.58 ± 0.50)in the weakening group,and(17.53 ± 7.60)ml and(12.86 ± 3.68)ml / s in the non contractile group,respectively,The postoperative residual urine was(40.08 ± 20.59)ml and Qmax was(10.73 ± 2.70)ml / s.The improvement of IPSS,QOL,residual urine and Qmax was different among the three groups.The improvement of normal group was more obvious than that of weakened group and non contractive group(P < 0.05).Conclusion: Our data suggest that Ho LEP is safe and effective in the treatment of BPH patients with detrusor dysfunction,and can significantly improve the urination symptoms of BPH patients.