Department of Urology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Department of Neurology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Biomed Res Int. 2019 Sep 30;2019:3875418. doi: 10.1155/2019/3875418. eCollection 2019.
Holmium laser enucleation of the prostate (HoLEP) is considered the standard endoscopic treatment of benign prostatic hyperplasia (BPH), but traditional HoLEP surgery will cause some postoperative complications. This study was attempted to evaluate the safety and efficacy of modified two-lobe technique versus traditional three-lobe technique of HoLEP focusing mainly on incidences of retrograde ejaculation (RE) and urinary incontinence (UI).
From March 2014 to February 2017, 191 men with BPH were randomly assigned to two groups: 97 underwent modified two-lobe technique; 94 underwent traditional three-lobe technique. All patients were followed up for 12 months. Primary outcomes were incidences of RE and UI, and secondary outcomes were international prostate symptom score (IPSS), quality of life (QOL), maximal urine flowing rate (MFR), and residual urine among the studied patients.
Compared with the traditional technique, patients in the modified group had a statistically significant decrease in frequency of UI (1.03% vs 8.51%, =0.036) and RE in the 6 month (33.33% vs 63.64%, =0.030) and 12 month (13.33% vs 50%, =0.034) and a significant increase in ejaculatory volume in the 6 month (=0.050) and 12 month (=0.003). Besides, the modified HoLEP was more beneficial to patients according to the change of QoL score at 1 month (=0.002), 3 months (=0.004), 6 months (=0.026), and 12 months (=0.015).
The modified two-lobe technology of HoLEP reduced the incidence of RE and UI, which improved the quality of life of the patients after surgery compared to the traditional three-lobe technology. This trial is registered with ChiCTR1800018553.
钬激光前列腺剜除术（HoLEP）被认为是治疗良性前列腺增生（BPH）的标准内镜治疗方法，但传统的 HoLEP 手术会引起一些术后并发症。本研究旨在评估改良双叶技术与传统三叶技术 HoLEP 的安全性和有效性，主要关注逆行射精（RE）和尿失禁（UI）的发生率。
2014 年 3 月至 2017 年 2 月，191 例 BPH 患者被随机分为两组：97 例行改良双叶技术；94 例行传统三叶技术。所有患者均随访 12 个月。主要结局为 RE 和 UI 的发生率，次要结局为国际前列腺症状评分（IPSS）、生活质量（QOL）、最大尿流率（MFR）和残余尿量。
与传统技术相比，改良组患者在术后 6 个月（33.33% vs 63.64%，=0.030）和 12 个月（13.33% vs 50%，=0.034）时 UI 的发生率（1.03% vs 8.51%，=0.036）和 RE 显著降低，6 个月（=0.050）和 12 个月（=0.003）时射精量显著增加。此外，改良 HoLEP 在术后 1 个月（=0.002）、3 个月（=0.004）、6 个月（=0.026）和 12 个月（=0.015）时 QoL 评分的变化更有利于患者。
与传统三叶技术相比，HoLEP 的改良双叶技术降低了 RE 和 UI 的发生率，提高了患者术后的生活质量。本试验在中国临床试验注册中心注册，注册号 ChiCTR1800018553。
