摘要
目的观察经尿道柱状水囊前列腺扩开术(TUCBDP)与经尿道前列腺等离子电切术(TUPKP)治疗小体积(≤30 mL)良性前列腺增生(BPH)的疗效及其对尿控与性功能的影响。方法回顾性分析2021年6月—2022年1月于山东大学齐鲁医院德州医院泌尿外科行手术治疗的BPH患者的资料。选取前列腺体积≤30 mL、有规律性生活的95例患者作为研究对象。将采用TUCBDP治疗的45例作为TUCBDP组,采用TUPKP治疗的50例作为TUPKP组,随访12个月,对两组患者的围手术期数据及随访结果进行分析。结果TUCBDP组手术时间、术中出血量、术后血红蛋白(Hb)下降量及血清Na+下降量、膀胱冲洗时间、术后疼痛视觉模拟评分(VAS)、尿管保留时间及术后住院时间均少于TUPKP组(P<0.05);两组患者术后12个月时尿控指标:国际前列腺症状评分(IPSS)、生活质量评分(QoL)、残余尿量(PVR)、最大尿流率(Qmax)较术前比较均有显著好转(P<0.05);两组患者术后12个月勃起功能指标:国际勃起功能评分(IIEF-5)、勃起硬度分级(EHS)、早泄患者性功能-5(CIPE-5)评分均较术前无显著变化(P>0.05);术后12个月射精情况:TUPKP组射精功能评分及射精困扰度评分均较术前变差(P<0.05),而TUCBDP组无明显变化(P>0.05),且该两指标TUCBDP组优于TUPKP组;TUCBDP组并发症发生率比TUPKP组显著降低(P<0.05)。结论TUCBDP术式治疗小体积(≤30 mL)BPH安全、有效,创伤小、生化干扰小、疼痛轻、并发症少、病程短,对患者的射精功能及勃起功能影响小,对要求保留性功能的患者更为适用。
Objective To explore the efficacy of transurethral columnar balloon dilation of prostate(TUCBDP)and transurethral bipolar plasmakinetic resection of prostate(TUPKP)for patients with small volume(≤30 mL)benign prostatic hyperplasia(BPH)and the effects on urinary control and sexual function.Methods Clinical data of BPH patients who underwent surgical treatment during Jun.2021 and Jan.2022 were reviewed.A total of 95 patients with prostate volume≤30 mL and regular sexual life were selected as subjects,including 45 patients who received TUCBDP as the TUCBDP group and 50 patients who received TUPKP as the TUPKP group.The patients were followed up for 12 months,and the perioperative data and follow-up results were analyzed.Results The TUCBDP group had shorter operation time,less intraoperative blood loss,less postoperative hemoglobin loss and sodium concentration loss,shorter bladder irrigation time,lower pain score,shorter urinary tube indwelling time and shorter hospital stay than the TUPKP group(P<0.05).Twelve months after surgery,the International Prostate Symptom score(IPSS),quality of life score(QoL),residual urine volume(PVR)and maximum urine flow rate(Qmax)were significantly improved in both groups(P<0.05).The International Index of Erectile Function-5(IIEF-5),Erection Hardness Grading Score(EHS),Sexual Function Score in Patients with Premature Ejaculation-5(CIPE-5)score had no significant differences compared with those before surgery(P>0.05).The TUPKP group had worse ejaculation function score and ejaculation disturbance score after surgery(P<0.05),while the TUCBDP group had no significant change(P>0.05),and the two indexes were superior in the TUCBDP group than in the TUPKP group.The TUCBDP group had significantly lower complication rate than the TUPKP group(P<0.05).Conclusion TUCBDP is safe and effective in the treatment of small volume(≤30 mL)BPH,less trauma,less biochemical interference,less pain,fewer complications,and shorter course of disease.It has little effect on the ejaculation function and erectile function,and is more suitable for patients requiring retention of sexual function.It has a good application prospect in the treatment of small volume BPH.
作者
杨元元
宋臻
高立健
赵书恒
姚军梅
李静
徐忠华
宋海滨
YANG Yuanyuan;SONG Zhen;GAO Lijian;ZHAO Shuheng;YAO Junmei;LI Jing;XU Zhonghua;SONG Haibin(Department of Urology,Qilu Hospital of Shandong University Dezhou Hospital,Dezhou 253000;Department of Pathology,Qilu Hospital of Shandong University Dezhou Hospital,Dezhou 253000;Operating Room,Qilu Hospital of Shandong University Dezhou Hospital,Dezhou 253000;Department of Urology,Qilu Hospital of Shandong University,Ji nan 250063,China)
出处
《现代泌尿外科杂志》
CAS
2023年第12期1046-1052,共7页
Journal of Modern Urology
关键词
经尿道柱状水囊前列腺扩开术
经尿道前列腺等离子电切术
小体积前列腺
性功能
良性前列腺增生症
尿控
transurethral columnar balloon dilation of prostate
transurethral bipolar plasmakinetic resection of prostate
small volume prostate
sexual function
benign prostatic hyperplasia
urinary control
