Wei Jingchao, Zhang Shigeng, Wang Bohan, Ke Mang, Liu Sheng, Yang Zhengjia, Zhou Guoyun, Qian Jiacheng, Lv Wenhui, Fan Yi, Shi Zhan, Wan Lijun, Chen Yongliang, He Jinkui, Liang Hui, Long Huimin, Wang Shijian, Wang Hao, Chen Bing, Shao Huan, Yang Binbin, Sun Chengfang, Huangfu Qi, Du Chuanjun, Cai Ming, Wen Jiaming
Department of Urology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Department of Urology, Taizhou Hospital of Zhejiang Province, Taizhou, China.
Transl Androl Urol. 2022 Feb;11(2):213-227. doi: 10.21037/tau-21-1138.
Transurethral split of the prostate (TUSP) is effective in treating benign prostatic hyperplasia (BPH). However, there is still a lack of research focusing on the optimal target population for TUSP. This study aimed to compare the efficacy of TUSP in patients with different prostate volumes or ages.
The study was a multicenter retrospective study. The outcomes of TUSP in BPH patients with different prostate volumes or different ages were compared. A total of 439 patients were included in the study. Patients were divided into two groups according to prostate volume, with a cut-off value of 50 mL. Similarly, the cut-off value for the age groups was 70 years. Baseline patient characteristics and perioperative outcomes were recorded. Follow-up was performed at 1, 6, and 12 months after surgery.
The mean age of the patients was 73.4 years, and the mean prostate volume was 51.2 mL. At 12-month follow-up after TUSP treatment, the patients' International Prostate Symptom Scores (IPSS), quality of life (QoL) scores, and postvoid residual (PVR) volumes decreased significantly, while peak urinary flow rate (Qmax) increased significantly. Intraoperative hemoglobin (Hb) reduction was significantly lower in the small volume group than in the large volume group. The incidence of postoperative urinary urgency and transient incontinence was lower in the small volume group. IPSS score, PVR, and Qmax in the small volume group showed more remarkable changes at several time points compared to the preoperative period. Postoperative pain scores were higher in the small volume group than in the large volume group. There were no differences between the two groups in terms of long-term complications. The younger group showed greater variation in PVR and Qmax at some time points but less variation in QoL than the older group.
TUSP is overall safe and effective in treating BPH. This study showed differences in the outcomes of TUSP in treating different prostate volumes or ages of BPH patients. The optimal surgical approach for BPH patients might be selected clinically based on a combination of prostate volume or patient age.
经尿道前列腺劈开术（TUSP）在治疗良性前列腺增生（BPH）方面有效。然而，仍缺乏针对TUSP最佳目标人群的研究。本研究旨在比较TUSP在不同前列腺体积或年龄患者中的疗效。
本研究为多中心回顾性研究。比较了不同前列腺体积或不同年龄的BPH患者TUSP的结果。共有439例患者纳入研究。根据前列腺体积将患者分为两组，临界值为50 mL。同样，年龄组的临界值为70岁。记录患者的基线特征和围手术期结果。术后1、6和12个月进行随访。
患者的平均年龄为73.4岁，平均前列腺体积为51.2 mL。TUSP治疗后12个月随访时，患者的国际前列腺症状评分（IPSS）、生活质量（QoL）评分和残余尿量（PVR）显著降低，而最大尿流率（Qmax）显著增加。小体积组术中血红蛋白（Hb）降低明显低于大体积组。小体积组术后尿急和短暂性尿失禁的发生率较低。与术前相比，小体积组在几个时间点的IPSS评分、PVR和Qmax变化更显著。小体积组术后疼痛评分高于大体积组。两组在长期并发症方面无差异。较年轻组在某些时间点的PVR和Qmax变化较大，但QoL变化较老年组小。
TUSP治疗BPH总体安全有效。本研究显示TUSP在治疗不同前列腺体积或年龄的BPH患者时结果存在差异。临床上可根据前列腺体积或患者年龄综合选择BPH患者的最佳手术方式。
