Lin Dongxu, Luo Changcheng, Cui Kai, Xu Hao, Yuan Huixing, Luan Yang, Chen Zhong
Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Lasers Med Sci. 2025 May 17;40(1):226. doi: 10.1007/s10103-025-04478-9.
The purpose of this study is to compare the safety and efficacy of 1470 nm diode laser enucleation of the prostate (DiLEP) with modified bipolar transurethral resection of the prostate (B-TURP) in the surgical management of benign prostatic hyperplasia (BPH). 81 patients presenting with symptomatic BPH were randomly assigned to undergo either DiLEP (n = 41) or B-TURP (n = 40). Baseline properties, perioperative characteristics, complication data, and 12-month follow-up outcomes between both groups were comparatively analyzed. As a result, no significant differences were observed in basic properties between two groups. The 1470 nm DiLEP demonstrated comparable efficacy to B-TURP in improving maximum flow rate (Q), International Prostate Symptom Score (IPSS), post-void residual urine (PVR), and quality of life (QoL) score. However, compared to B-TURP, 1470 nm DiLEP exhibited superior retrieval efficiency (0.7 g/min vs. 0.5 g/min, P = 0.001), reduced blood loss (9.4 g/L vs. 13.7 g/L, P = 0.011), shorter operative duration (69.8 min vs. 96.2 min, P = 0.015), as well as decreased postoperative irrigation (17.8 h vs. 32.5 h, P = 0.003) and catheterization time (3.9 days vs. 6.0 days, P < 0.001). Surgical complications were somewhat less common in the DiLEP group than in the B-TURP group. Overall, one-year follow-up outcomes demonstrated that 1470 nm DiLEP exhibited comparable safety and efficacy in alleviating lower urinary tract symptoms (LUTS) and benign prostatic obstruction (BPO) to B-TURP. However, it showed superior surgical efficiency and enhanced hemostatic control in the resection of medium to large prostates compared to B-TURP.
本研究的目的是比较1470纳米二极管激光前列腺剜除术（DiLEP）与改良双极经尿道前列腺切除术（B-TURP）在良性前列腺增生（BPH）手术治疗中的安全性和有效性。81例有症状的BPH患者被随机分配接受DiLEP（n = 41）或B-TURP（n = 40）。对两组之间的基线特征、围手术期特点、并发症数据以及12个月的随访结果进行了比较分析。结果显示，两组之间的基本特征没有显著差异。1470纳米DiLEP在改善最大尿流率（Q）、国际前列腺症状评分（IPSS）、残余尿量（PVR）和生活质量（QoL）评分方面显示出与B-TURP相当的疗效。然而，与B-TURP相比，1470纳米DiLEP表现出更高的切除效率（0.7克/分钟对0.5克/分钟，P = 0.001）、减少的失血量（9.4克/升对13.7克/升，P = 0.011）、更短的手术时间（69.8分钟对96.2分钟，P = 0.015），以及减少的术后冲洗时间（17.8小时对32.5小时，P = 0.003）和导尿时间（3.9天对6.0天，P < 0.001）。DiLEP组的手术并发症比B-TURP组略少。总体而言，一年的随访结果表明，1470纳米DiLEP在缓解下尿路症状（LUTS）和良性前列腺梗阻（BPO）方面显示出与B-TURP相当的安全性和有效性。然而，与B-TURP相比，它在中到大型前列腺切除术中显示出更高的手术效率和更好的止血控制。
