Zhu Qing-yi, Gu Xiao-jian, Yuan Lin, Huang Wei-zhou, Zhang Li, Lu Zi-jie, Zhang Ping, Su Jian, Xu Yan, Zhang Yang
Department of Urology, Jiangsu Hospital of TCM, Nanjing University of TCM, Nanjing, Jiangsu 210029, China.
Zhonghua Nan Ke Xue. 2008 Oct;14(10):907-10.
To compare the safety and efficacy of the two surgical alternatives, transurethral bipolar vaporization resection of the prostate (TUBVP) and holmium laser enucleation of the prostate (HOLEP), in the treatment of large benign prostatic hyperplasia (BPH).
Retrospective analyses were made of 56 cases of large BPH ( >80 ml), 34 treated by TUBVP with the Bipolar Vaporization System (ACMI Medical Ltd, U.K.) at 160 W in cutting and 80 W in coagulation mode, and 22 by HOLEP with the Holmium Laser System (LUMNIS Ltd, US) at 100W. The safety and efficacy of the two approaches were assessed based on the operative and follow-up data.
Blood loss was significantly less in the HOLEP than in the TUBVP group ( P < 0.01), but the time of postoperative bladder irrigation and catheter indwelling was obviously shorter in the latter. IPSS, Qmax and Residual unine were markedly improved at 1 and 3 months after the surgery, with no statistically significant differences between the two groups.
Both TUBVP and HOLEP are safe and effective surgical options for the treatment of large BPH. Particularly the former, easier to be popularly applied, is promising to be a new "gold standard" in the surgical treatment of BPH.
比较经尿道双极前列腺汽化切除术（TUBVP）和钬激光前列腺剜除术（HOLEP）这两种手术方式治疗巨大良性前列腺增生（BPH）的安全性和有效性。
回顾性分析56例巨大BPH（>80 ml）患者，其中34例采用英国ACMI Medical Ltd公司的双极汽化系统行TUBVP，切割功率160 W，凝固功率80 W；22例采用美国LUMNIS Ltd公司的钬激光系统行HOLEP，功率100 W。根据手术及随访数据评估两种手术方式的安全性和有效性。
HOLEP组术中出血量明显少于TUBVP组（P < 0.01），但TUBVP组术后膀胱冲洗时间和留置导尿管时间明显较短。术后1个月和3个月时，两组国际前列腺症状评分（IPSS）、最大尿流率（Qmax）及残余尿量均明显改善，两组间差异无统计学意义。
TUBVP和HOLEP都是治疗巨大BPH安全有效的手术方式。尤其是TUBVP，更易于推广应用，有望成为BPH手术治疗的新“金标准”。
