Chiruvella Mallikarjuna, Enganti Bhavatej, Bendigeri Mohammed Taif, Ghouse Syed Mohammed, Ragoori Deepak, Reddy Purnachandra
Asian Institute of Nephrology and Urology, Hyderabad, India.
Asian Institute of Nephrology and Urology, Hyderabad, India.
Urology. 2018 Dec;122:147-151. doi: 10.1016/j.urology.2018.09.001. Epub 2018 Sep 13.
To present our transurethral enucleation with bipolar energy (TUEB) technique, wherein the enucleated adenoma is resected while keeping it attached near the verumontanum avoiding the need of a morcellator, and to evaluate the safety and short-term outcomes of our technique of TUEB for the treatment of symptomatic benign prostatic hypertrophy (BPH).
This was a retrospective evaluation of prospectively maintained database of patients with symptomatic BPH who underwent TUEB from January 2016 to September 2017. Patients with a minimum follow-up period of 6 months were included in the study. All patients were assessed using the international prostate symptom score (IPSS), uroflometry (Q-max), and transrectal ultrasonography (TRUS) of the prostate. TUEB was indicated for patients with total prostate volumes >60 g on TRUS. Postoperative outcome measures, including urinary incontinence, Q-max, and IPSS, were recorded at each follow-up visit.
A total of 103 patients underwent TUEB. The mean patient age was 64 ± 7 years, and the median operative time was 54 minutes (interquartile range [IQR]: 44-66). The median resected prostate weight was 39 g (IQR: 28-54 g), corresponding to approximately 87% of the assessed transitional zone volume. The mean postoperative hemoglobin drop of 1.08 ± 0.28 g/dL was clinically insignificant. There was significant improvement in the IPSS and Q-max postoperatively, when compared to baseline parameters (P < .05).
Our TUEB technique is safe and effective in treating symptomatic BPH with acceptable complications and favorable short-term outcomes. TUEB allows near-complete enucleation of a prostate adenoma, followed by resection, thus avoiding the need for a morcellator.
介绍我们的双极能量经尿道剜除术(TUEB)技术,即在前列腺腺瘤保持与精阜附近相连的情况下将其剜除并切除,无需使用粉碎器,并评估我们的TUEB技术治疗有症状良性前列腺增生(BPH)的安全性和短期疗效。
这是一项对2016年1月至2017年9月接受TUEB的有症状BPH患者前瞻性维护数据库的回顾性评估。研究纳入了随访期至少6个月的患者。所有患者均使用国际前列腺症状评分(IPSS)、尿流率测定(最大尿流率Q-max)和前列腺经直肠超声检查(TRUS)进行评估。TRUS显示前列腺总体积>60g的患者适合行TUEB。每次随访时记录术后结果指标,包括尿失禁、Q-max和IPSS。
共有103例患者接受了TUEB。患者平均年龄为64±7岁,中位手术时间为54分钟(四分位间距[IQR]:44 - 66分钟)。切除的前列腺中位重量为39g(IQR:28 - 54g),约占评估移行区体积的87%。术后平均血红蛋白下降1.08±0.28g/dL,在临床上无显著意义。与基线参数相比,术后IPSS和Q-max有显著改善(P <.05)。
我们的TUEB技术在治疗有症状BPH方面安全有效,并发症可接受,短期疗效良好。TUEB可近乎完全剜除前列腺腺瘤,随后进行切除,从而无需使用粉碎器。