Zhou Zi-Peng, Dong Yue-Hua, Wang Cong-Bo, Zhou Xing-Bo, Su Ze-Man
Department of General Surgery, Qinhuangdao Workers' Hospital, Qinhuangdao, Hebei 066200, China.
Department of Cardiothoracic Surgery, The First Hospital Affiliated to Hebei North College, Zhangjiakou, Hebei 075000, China.
Zhonghua Nan Ke Xue. 2024 Jul;30(7):620-626.
To compare the effects of transurethral resection of the prostate (TURP) and transurethral columnar balloon dilatation of the prostate (TUCBDP) in the treatment of BPH.
This study included 218 BPH patients treated in Qinhuangdao Workers' Hospital from July 2021 to November 2022, 109 by TURP and the other 109 by TUCBDP. We followed up the patients for 12 months, observed their postoperative recovery, complications, serum pain, inflammatory index, cytokine level, urodynamic index, symptom improvement and quality of life (QOL) and compared the data obtained between the two groups of patients.
At 12 months after surgery, the total effectiveness rate was significantly higher in the TUCBDP than in the TURP group (93.58% vs 84.40%, P< 0.05), and the postoperative recovery was better in the former than in the latter (P< 0.05). Compared with the baseline, the levels of serum prostaglandin E2 (PGE2), substance P, tumor necrosis factor-alpha (TNF-α) and high sensitive C-reactive protein (hs-CRP) were remarkably increased in both of the groups on the first day after surgery (P< 0.05), more significantly in the TURP than in the TUCBDP group (P< 0.05), while the levels of serum PSA and E2 decreased and the T level elevated in all the patients at 3 months postoperatively (P< 0.05), more significantly in the TUCBDP than in the TURP group (P< 0.05). Before and at 3 and 12 months after operation, the postvoid residual urine volume (PVR) and NIH-CPSI, IPSS and QOL scores showed a decreasing trend, while the maximum urinary flow rate (Qmax), maximum cystometric capacity (MCC) and maximum urethral closure pressure (MUCP) exhibited an increasing trend in both of the two groups, even more significantly in the TUCBDP than in the TURP group (P< 0.05).
TUCBDP is advantageous over TURP in promoting postoperative recovery, improving QOL, reducing postoperative pain, inflammation and complications, regulating the levels of serum cytokines, and improving urodynamics and clinical symptoms in BPH patients. However, with the extension of postoperative time, the two strategies are basically comparable in improving the urodynamics, symptoms and QOL of the patients.
比较经尿道前列腺切除术(TURP)和经尿道柱状气囊前列腺扩张术(TUCBDP)治疗良性前列腺增生(BPH)的效果。
本研究纳入2021年7月至2022年11月在秦皇岛工人医院接受治疗的218例BPH患者,其中109例行TURP,另109例行TUCBDP。对患者进行12个月的随访,观察其术后恢复情况、并发症、血清疼痛、炎症指标、细胞因子水平、尿动力学指标、症状改善情况及生活质量(QOL),并比较两组患者获得的数据。
术后12个月,TUCBDP组的总有效率显著高于TURP组(93.58%对84.40%,P<0.05),且前者术后恢复情况优于后者(P<0.05)。与基线相比,两组患者术后第1天血清前列腺素E2(PGE2)、P物质、肿瘤坏死因子-α(TNF-α)和高敏C反应蛋白(hs-CRP)水平均显著升高(P<0.05),TURP组升高更明显(P<0.05);术后3个月所有患者血清PSA和E2水平降低,T水平升高(P<0.05),TUCBDP组变化更显著(P<0.05)。术前及术后3个月和12个月,两组患者的残余尿量(PVR)、美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI)、国际前列腺症状评分(IPSS)及QOL评分均呈下降趋势,而最大尿流率(Qmax)、最大膀胱测压容量(MCC)和最大尿道闭合压(MUCP)均呈上升趋势,TUCBDP组变化更显著(P<0.05)。
TUCBDP在促进BPH患者术后恢复、改善生活质量、减轻术后疼痛、炎症及并发症、调节血清细胞因子水平、改善尿动力学及临床症状方面优于TURP。然而,随着术后时间的延长,两种治疗策略在改善患者尿动力学、症状及生活质量方面基本相当。