经尿道钬激光前列腺剜除术与双极经尿道前列腺切除术治疗良性前列腺增生症的安全性和有效性：一项前瞻性随机对照试验。
Safety and efficacy of transurethral holmium laser enucleation of the prostate versus bipolar transurethral resection of the prostate in the treatment of benign prostatic hyperplasia: a prospective randomized controlled trial.
机构信息
Department of Urology, Haiyan People's Hospital, Haiyan, Zhejiang, 314300, China.
The Yangtze River Delta Biological Medicine Research and Development Center of Zhejiang Province, Yangtze Delta Region Institution of Tsinghua University, Hangzhou, Zhejiang, 314006, China.
出版信息
Langenbecks Arch Surg. 2024 Oct 19;409(1):313. doi: 10.1007/s00423-024-03499-2.
PURPOSE
To evaluate the safety and efficacy of transurethral holmium laser enucleation of the prostate (HoLEP) compared to bipolar transurethral resection of the prostate (bTUR-P) in the treatment of benign prostatic hyperplasia (BPH).
METHODS
A total of 220 BPH patients hospitalized from January 2022 to September 2023 were included in this study. These patients were randomly assigned to HoLEP and bTUR-P groups, with 110 participants in each group. We collected preoperative general information, perioperative data, complications, and postoperative follow-up indicators from both groups of patients.
RESULTS
The baseline characteristics of patients in both groups were similar, with no statistical significance (P > 0.05). Compared to the bTUR-P group, the HoLEP group exhibited significantly less intraoperative bleeding (P < 0.001), shorter bladder irrigation time (P = 0.002), shorter catheter retention time (P < 0.001), and reduced postoperative hospitalization (P = 0.002). Additionally, the pain score during urination after catheter removal was significantly lower in the HoLEP group (P < 0.001). Postoperative complications occurred in both groups; however, they were less frequent in the HoLEP group (4 cases), primarily consisting of urinary retention and postoperative bleeding. The bTUR-P group experienced more complications (9 cases). Significant reductions in postoperative residual urine volume (RUV) were observed in both groups (P < 0.001). Both groups also showed significant improvements in Quality of Life (QoL) scores and International Prostate Symptom Scores (IPSS), with the HoLEP group demonstrating a more significant decrease in IPSS (P < 0.001).
CONCLUSION
After comprehensive evaluation, HoLEP was superior to bTUR-P in terms of safety and efficacy. Therefore, HoLEP may be a preferable choice for the treatment of BPH.
目的
评估经尿道钬激光前列腺剜除术（HoLEP）与双极经尿道前列腺切除术（bTUR-P）治疗良性前列腺增生（BPH）的安全性和疗效。
方法
本研究纳入了 2022 年 1 月至 2023 年 9 月期间住院的 220 例 BPH 患者。这些患者被随机分配到 HoLEP 和 bTUR-P 组，每组 110 例。我们从两组患者中收集了术前一般信息、围手术期数据、并发症和术后随访指标。
结果
两组患者的基线特征相似，无统计学意义（P>0.05）。与 bTUR-P 组相比，HoLEP 组术中出血量明显减少（P<0.001），膀胱冲洗时间更短（P=0.002），导尿管留置时间更短（P<0.001），术后住院时间缩短（P=0.002）。此外，HoLEP 组拔除导尿管后排尿时的疼痛评分明显更低（P<0.001）。两组均发生术后并发症，但 HoLEP 组的并发症较少（4 例），主要为尿潴留和术后出血。bTUR-P 组发生的并发症更多（9 例）。两组术后残余尿量（RUV）均显著减少（P<0.001）。两组的生活质量（QoL）评分和国际前列腺症状评分（IPSS）均显著改善，HoLEP 组的 IPSS 显著降低（P<0.001）。
结论
经过综合评估，HoLEP 在安全性和疗效方面优于 bTUR-P。因此，HoLEP 可能是治疗 BPH 的首选方法。
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