Aydogdu Ozgu, Karakose Ayhan, Atesci Yusuf Ziya
Izmir University School of Medicine, Department of Urology, Izmir, Turkey.
Can Urol Assoc J. 2014 Jul;8(7-8):E485-9. doi: 10.5489/cuaj.1772.
We compare BIVAP saline vaporization of the prostate with bipolar transurethral resection of the prostate (TURP) in the treatment of benign prostatic hyperplasia.
In total, we included 86 patients treated with BIVAP (n = 44) and bipolar TURP (n = 42). The inclusion criteria were maximum urinary flow rate (Qmax) ≤10 mL/s, International Prostate Symptom Score (IPSS) ≥16, and prostate volume measured with transrectal ultrasound scan between 30 and 80 mL. Serum electrolyte, hemoglobin, and hematocrit levels were determined preoperatively and postoperatively. All patients were evaluated at the postoperative first and third months and the IPSS score, post-void residual urinary volume (PVR), Qmax, and average urinary flow rate (Qave) were compared. Statistical analyses were performed using SPSS 16.0 program and statistical significance was set at p < 0.05.
Preoperative demographic characteristics were similar in the 2 groups. The mean operation time was significantly higher (p = 0.02) and hospitalization time was significantly lower (p = 0.04) in the BIVAP group when compared to the bipolar TURP group. There was no significant difference between 2 groups in terms of preoperative and postoperative serum electrolyte, hemoglobin and hematocrit levels. Postoperative complication rates were similar in the 2 groups. The only exception was the rate of severe dysuria, which was significantly higher in the BIVAP group. No statistical difference was noted between the groups in terms of postoperative follow-up results.
Bipolar TURP is a safe and highly effective technique which can be used in the surgical treatment of benign prostatic obstruction with minimal side effects. BIVAP saline vaporization of the prostate seems to be a potential alternative to bipolar TURP with shorter hospitalization time.
我们比较了前列腺双极汽化盐水消融术(BIVAP)与双极经尿道前列腺切除术(TURP)治疗良性前列腺增生的效果。
我们共纳入86例接受BIVAP治疗的患者(n = 44)和接受双极TURP治疗的患者(n = 42)。纳入标准为最大尿流率(Qmax)≤10 mL/s、国际前列腺症状评分(IPSS)≥16,经直肠超声扫描测量的前列腺体积在30至80 mL之间。术前和术后测定血清电解质、血红蛋白和血细胞比容水平。所有患者在术后第1个月和第3个月进行评估,比较IPSS评分、排尿后残余尿量(PVR)、Qmax和平均尿流率(Qave)。使用SPSS 16.0程序进行统计分析,设定统计学显著性为p < 0.05。
两组患者术前人口统计学特征相似。与双极TURP组相比,BIVAP组的平均手术时间显著更长(p = 0.02),住院时间显著更短(p = 0.04)。两组术前和术后血清电解质、血红蛋白和血细胞比容水平无显著差异。两组术后并发症发生率相似。唯一的例外是严重尿痛发生率,BIVAP组显著更高。两组术后随访结果无统计学差异。
双极TURP是一种安全有效的技术,可用于良性前列腺梗阻的手术治疗,副作用最小。前列腺BIVAP盐水消融术似乎是双极TURP的一种潜在替代方法,住院时间更短。