Erturhan Sakıp, Bayrak Ömer, Seçkiner İlker, Demirbağ Asaf, Erbağcı Ahmet, Yağcı Faruk
Department of Urology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey.
Turk J Urol. 2013 Dec;39(4):220-5. doi: 10.5152/tud.2013.057.
We compared results from the standard monopolar or the bipolar plasmakinetic method for the transurethral resection of the prostate (TURP) due to benign prostatic hyperplasia (BPH) at 4 and 7 years after surgery (medium to long term).
A retrospective analysis was performed on the complete data from 124 patients who were alive and had 7 years of regular follow-up. Of those 124 patients with BPH, 65 (52%) underwent monopolar TURP (M-TURP) and 59 (48%) underwent plasmakinetic TURP (P-TURP). During the follow-up period, the International Prostate Symptom Score (IPSS), the maximal flow rate (Qmax) measured using uroflowmetry and the prostate specific antigen (PSA) values were recorded. Patients in whom alpha blockers were administered due to the growth of postoperative adenoma and who had been operated on due to urethral stricture, bladder neck contracture or a growing adenoma were also noted and recorded.
There was no statistically significant difference between M-TURP and P-TURP groups in any pre-operative or post-operative follow-up parameter at 4 or 7 years post-surgery. Specifically, PSA, IPSS and Qmax values; urethrotomies performed; alpha-blocker use; and the frequency of re-operations were statistically insignificant (p>0.05).
Our study demonstrated that when medium-to long-term results are compared, P-TURP and M-TURP appear to result in similar IPSS scores, Qmax values, complication rates and retreatment rates. Larger prospective studies are required to corroborate these results.
我们比较了因良性前列腺增生(BPH)接受经尿道前列腺切除术(TURP)的患者,在术后4年和7年(中长期)采用标准单极或双极等离子体动力方法的手术结果。
对124例存活且有7年定期随访完整数据的患者进行回顾性分析。在这124例BPH患者中,65例(52%)接受了单极TURP(M-TURP),59例(48%)接受了等离子体动力TURP(P-TURP)。在随访期间,记录国际前列腺症状评分(IPSS)、通过尿流率测定法测得的最大尿流率(Qmax)以及前列腺特异性抗原(PSA)值。还记录了因术后腺瘤生长而服用α受体阻滞剂的患者,以及因尿道狭窄、膀胱颈挛缩或腺瘤生长而接受手术的患者。
在术后4年或7年的任何术前或术后随访参数方面,M-TURP组和P-TURP组之间均无统计学显著差异。具体而言,PSA、IPSS和Qmax值;尿道切开术的实施情况;α受体阻滞剂的使用;以及再次手术的频率在统计学上均无显著差异(p>0.05)。
我们的研究表明,从中长期结果比较来看,P-TURP和M-TURP似乎在IPSS评分、Qmax值、并发症发生率和再治疗率方面结果相似。需要更大规模的前瞻性研究来证实这些结果。