Liao Naikai, Yu JianJun
Department of Urology, the Affiliated Hospital of Shanghai JiaoTong University, Shanghai Sixth People's Hospital, Shanghai, China.
Photomed Laser Surg. 2012 Jun;30(6):320-4. doi: 10.1089/pho.2011.3181. Epub 2012 Apr 3.
The aim of this study was to evaluate the safety and efficiency of transurethral bipolar plasmakinetic resection of the prostate (PKRP) combined with 2 μm laser vaporization in the management of large prostates (>80 mL).
The safety and efficiency of transurethral vaporesection of the prostate with benign prostatic hyperplasia (BPH), using a 2 μm laser system, have been verified. However, this method does still not manage large volume prostates efficiently.
From October 2009 to June 2010, 120 BPH patients with a median prostatic volume of 106.7 (±16.7) mL (range, 82.5-156.8 mL) were randomized for surgical treatment with PKRP combined with 2 μm laser vaporization (n=58) or PKRP only (n=62). All patients were preoperatively assessed with subjective symptoms score. Preoperative and perioperative parameters at 3-, 6-, and 9-month follow-up were also evaluated. All complications were recorded.
PKRP combined with 2 μm laser vaporization was significantly superior to PKRP alone in terms of operative time, irrigation time, catheterization time, hospital stay, and hemoglobin decrease. The blood transfusion and urinary tract infection observed in the PKRP combined with 2 μm laser vaporization group was significantly less than that of the groups that received PKRP only. Both groups were similar with respect to resected tissue weight, transient incontinence, urethral stricture and retrograde ejaculation in the postoperative period. Both groups showed a significant improvement from baseline in terms of International Prostate Symptom Score (IPSS), quality of life (QOL), maximum urinary flow rate (Qmax), and pulmonary vascular resistance unit (PVRU) values. However, no significant difference was found between them.
PKRP combined with 2 μm laser vaporization, which combines the advantages of both PKRP and 2 μm laser, is superior for its shorter operation time, less bleeding, and better efficiency. It may be a safer and more effective method for the treatment of BPH in large prostates.
本研究旨在评估经尿道双极等离子体前列腺切除术（PKRP）联合2μm激光汽化术治疗大体积前列腺（>80mL）的安全性和有效性。
使用2μm激光系统进行经尿道前列腺汽化术治疗良性前列腺增生（BPH）的安全性和有效性已得到验证。然而，该方法仍无法有效治疗大体积前列腺。
2009年10月至2010年6月，120例BPH患者，前列腺中位体积为106.7（±16.7）mL（范围82.5 - 156.8mL），随机分为PKRP联合2μm激光汽化术治疗组（n = 58）和单纯PKRP治疗组（n = 62）。所有患者术前均进行主观症状评分。还评估了术前及术后3个月、6个月和9个月的围手术期参数。记录所有并发症。
PKRP联合2μm激光汽化术在手术时间、冲洗时间、导尿时间、住院时间和血红蛋白降低方面明显优于单纯PKRP。PKRP联合2μm激光汽化术组观察到的输血和尿路感染明显少于单纯接受PKRP的组。两组在术后切除组织重量、短暂性尿失禁、尿道狭窄和逆行射精方面相似。两组在国际前列腺症状评分（IPSS）、生活质量（QOL）、最大尿流率（Qmax）和肺血管阻力单位（PVRU）值方面均较基线有显著改善。然而，两组之间未发现显著差异。
PKRP联合2μm激光汽化术结合了PKRP和2μm激光的优点，具有手术时间短、出血少、效率更高的优势。它可能是治疗大体积前列腺BPH的一种更安全、有效的方法。
