Liu Ding-yi, Gu Jiong, Zhang Chong-yu, Wang Jian, Tang Qi, Zhou Yan-feng, Zhou Wen-long, Wang Ming-wei, Zhu Yu, Zhao Ju-ping
Department of Urology, Punan Hospital, Shanghai 200125, China.
Zhonghua Wai Ke Za Zhi. 2009 Apr 1;47(7):545-7.
To evaluate therapeutic effect and reliability of bipolar transurethral plasma kinetic prostatectomy (TUPKP) for high risk level benign prostatic hyperplasia (BPH).
A total of 230 cases of high risk of BPH were treated with TUPKP. Among them, 132 cases with the residual urine of 40 to 420 ml had accepted long term but inefficient medical therapy, 98 cases were suffered with repeating acute urinary retention. One hundred and seventy-three cases with the functional capacity>4 MET were performed the standard transurethral resection of the prostate (TURP), the other 57 cases with the functional capacity<4 MET were accepted the minimally invasive TURP. Among them 12 cases complicated with bladder stones accepted Ho: YAG lithotripsy priory. The international prostate symptom score (IPSS), The maximal urinary flow rate (Qmax) and residual urine of the 2 groups before and after operation were analyzed.
There was no transurethral resection syndrome occurred in both groups. After 3 to 12 months of follow-up postoperatively, the IPSS of the two groups were reduced from (21.9+/-5.7) and (23.7+/-5.0) to (4.4+/-2.3) and (5.5+/-2.4), residual urine were reduced from (61.8+/-18.4) ml and (103.9+/-77.3) ml to (13.0+/-6.2) ml and (15.8+/-6.1) ml, respectively. The Qmax was increased from (5.7+/-3.0) ml/s and (4.8+/-2.8) ml/s to (20.9+/-6.3) ml/s and (16.8+/-3.9) ml/s, there existed significant differences (P<0.01). However the IPSS, Qmax and residual urine of the standard group had progressed more obviously than the minimally invasive TURP group (P<0.05).
It is safe and effective to use TUPKP for treating high risk patients of BPH with classic TURP and minimally invasive TURP according to different functional capacity. When the functional capacity is more than 4 MET, the standard procedures is preferred.
评估双极经尿道等离子体动力学前列腺切除术(TUPKP)治疗高危良性前列腺增生(BPH)的疗效及安全性。
230例高危BPH患者接受TUPKP治疗。其中,132例残余尿量为40至420ml的患者接受了长期但无效的药物治疗,98例曾反复发生急性尿潴留。173例功能能力>4代谢当量(MET)的患者接受了标准经尿道前列腺切除术(TURP),另外57例功能能力<4 MET的患者接受了微创TURP。其中12例合并膀胱结石的患者先行钬激光碎石术。分析两组手术前后的国际前列腺症状评分(IPSS)、最大尿流率(Qmax)及残余尿量。
两组均未发生经尿道切除综合征。术后随访3至12个月,两组IPSS分别从(21.9±5.7)和(23.7±5.0)降至(4.4±2.3)和(5.5±2.4),残余尿量分别从(61.8±18.4)ml和(103.9±77.3)ml降至(13.0±6.2)ml和(15.8±6.1)ml。Qmax分别从(5.7±3.0)ml/s和(4.8±2.8)ml/s增至(20.9±6.3)ml/s和(16.8±3.9)ml/s,差异有统计学意义(P<0.01)。但标准组的IPSS、Qmax及残余尿量改善程度明显优于微创TURP组(P<0.05)。
根据不同功能能力,采用TUPKP对高危BPH患者行经典TURP及微创TURP治疗安全有效。当功能能力>4 MET时,首选标准术式。