Li Yuanwei, Yang Yongjun, Chen Junjie, Li Zhuo, Song Guangqing, Chen Jia, Zhe Liu, Teng Yili, Lu Qiang
Department of Urology, Hunan Provincial People's Hospital (First Affiliated Hospital of Hunan Normal University), Changsha, Hunan Province, China.
Wideochir Inne Tech Maloinwazyjne. 2024 Aug 8;19(3):370-376. doi: 10.20452/wiitm.2024.17897. eCollection 2024 Oct 16.
Population aging is associated with increased incidence of benign prostatic hyperplasia (BPH), which may be complicated by bladder stones (BSs). The conditions are successfully treated with transurethral enucleation of the prostate (TUEP) plus bladder lithotomy. However, open surgery is associated with higher blood loss, larger incisions, prolonged operative time, and may impede patient recovery.
This work explored the feasibility, safety, and efficacy of using thulium laser enucleation of the prostate (ThuLEP) and thulium fiber laser (TFL) on a single‑energy platform to treat BPH combined with BS.
Thirty‑one patients with BPH complicated by BSs who underwent ThuLEP+TFL at our institution between October 2020 and September 2022 were included in the observation group, while 31 patients undergoing TUEP plus bladder lithotomy during the same period constituted the control group. Data collection involved assessing differences in the International Prostate Symptom Score (IPSS), hemoglobin (Hb) levels, maximum urinary flow rate (Q), and quality of life (QoL) before and after surgery, along with follow‑up results.
The patients in the observation group exhibited lower surgery duration, smaller postoperative decrease in Hb levels, shorter duration of postoperative indwelling catheterization, and proportion of American Society of Anesthesiologists (ASA) II patients, with a higher proportion of ASA I patients than the individuals in the control group ( <0.05). Additionally, in comparison with the control group, the patients in the observation group had lower postoperative IPSS scores and higher levels of Hb, Q, and QoL score ( <0.05). There was no significant difference in the postoperative stone clearance rate between the 2 groups ( >0.05); however, the postoperative length of hospital stay was shorter in the observation group ( <0.05), with a higher incidence of complications in the control ( <0.05).
In summary, ThuLEP+TFL surgery was safe and feasible in treating BPH+BS, relieving the symptoms, and improving QoL.
人口老龄化与良性前列腺增生（BPH）发病率增加相关，BPH可能并发膀胱结石（BS）。经尿道前列腺剜除术（TUEP）加膀胱切开取石术可成功治疗这些病症。然而，开放手术会导致更多失血、切口更大、手术时间延长，并可能妨碍患者康复。
本研究探讨在单一能量平台上使用铥激光前列腺剜除术（ThuLEP）和铥光纤激光（TFL）治疗BPH合并BS的可行性、安全性和疗效。
选取2020年10月至2022年9月在我院接受ThuLEP+TFL治疗的31例BPH合并BS患者作为观察组，同期31例行TUEP加膀胱切开取石术的患者作为对照组。收集的数据包括评估手术前后国际前列腺症状评分（IPSS）、血红蛋白（Hb）水平、最大尿流率（Q）和生活质量（QoL）的差异以及随访结果。
观察组患者手术时间较短，术后Hb水平下降幅度较小，术后留置导尿管时间较短，美国麻醉医师协会（ASA）II级患者比例较低，ASA I级患者比例高于对照组（<0.05）。此外，与对照组相比，观察组患者术后IPSS评分较低，Hb、Q和QoL评分较高（<0.05）。两组术后结石清除率差异无统计学意义（>0.05）；然而，观察组术后住院时间较短（<0.05），对照组并发症发生率较高（<0.05）。
综上所述，ThuLEP+TFL手术治疗BPH+BS安全可行，可缓解症状并改善生活质量。
