Wang Rong, Xu Bin, Huang Wei-Hua, Xu Yun-Hua
Department of Urology, Jintan People's Hospital Affiliated to Jiangsu University, Jintan, Jiangsu 213200, China.
Department of Urology, Zhongda Hospital of Southeast University, Nanjing, Jiangsu 210009, China.
Zhonghua Nan Ke Xue. 2020 Mar;26(3):242-249.
To compare the clinical effect and safety of monoplane holmium laser enucleation of the prostate (MP-HoLEP) from those of biplane HoLEP (BP-HoLEP) in the treatment of large-volume BPH.
We retrospectively analyzed the clinical data on 67 cases of large-volume BPH treated in Jintan People's Hospital from June 2017 to December 2018, 30 by MP-HoLEP with incisions at 5- and 7-o'clock positions beside the verumontanum and the other 37 by BP-HoLEP with incision at 12 o'clock in the bladder neck to expose the surgical capsule layer. We compared the perioperative, postoperative and follow-up data between the two groups of patients.
There were no statistically significant differences between the two groups of patients in the age, disease course, prostate volume or preoperative post-void residual urine volume (PVR), maximum urine flow rate (Qmax), IPSS, PSA level and quality of life score (QOL). Compared with the patients in the MP-HoLEP group, those treated by BP-HoLEP showed a significantly shorter operation time (［97.65 ± 34.72］ vs ［125.46 ± 47.58］ min, P < 0.01) and tissue-enucleation time (［60.34 ± 23.45］ vs ［97.43 ± 35.51］ min, P < 0.01) and lower intraoperative level of hemoglobin (［14.58 ± 1.11］ vs ［21.44 ± 1.28］ g, P < 0.01). Statistically significant differences were not observed in the intraoperative adverse events, volume of the resected tissue, time of bladder irrigation or length of postoperative hospital stay, nor in the incidence of transient urinary incontinence (33% vs36.8%, P > 0.05). PVR, Qmax, IPSS and QOL were improved similarly in both of the groups at 6 months postoperatively.
Both MP-HoLEP and BP-HoLEP are definitely effective for the treated of large-volume BPH, but the latter is superior to the former for shorter operation and enucleation time and less bleeding.
比较单平面钬激光前列腺剜除术（MP-HoLEP）与双平面HoLEP（BP-HoLEP）治疗大体积良性前列腺增生（BPH）的临床疗效及安全性。
回顾性分析2017年6月至2018年12月在金坛市人民医院接受治疗的67例大体积BPH患者的临床资料，其中30例行MP-HoLEP，在精阜旁5点和7点位置切开；另外37例行BP-HoLEP，在膀胱颈12点位置切开以暴露手术包膜层。比较两组患者的围手术期、术后及随访数据。
两组患者在年龄、病程、前列腺体积、术前排尿后残余尿量（PVR）、最大尿流率（Qmax）、国际前列腺症状评分（IPSS）、前列腺特异抗原（PSA）水平及生活质量评分（QOL）方面差异均无统计学意义。与MP-HoLEP组患者相比，BP-HoLEP组患者的手术时间（［97.65±34.72］vs［125.46±47.58］分钟，P<0.01）和组织剜除时间（［60.34±23.45］vs［97.43±35.51］分钟，P<0.01）明显更短，术中血红蛋白水平更低（［14.58±1.11］vs［21.44±1.28］克，P<0.01）。两组患者术中不良事件、切除组织体积、膀胱冲洗时间、术后住院时间以及暂时性尿失禁发生率（33%对36.8%，P>0.05）差异均无统计学意义。术后6个月时，两组患者的PVR、Qmax、IPSS及QOL改善情况相似。
MP-HoLEP和BP-HoLEP治疗大体积BPH均有确切疗效，但BP-HoLEP在手术及剜除时间方面更短，出血更少，优于MP-HoLEP。
