HoLEP改良术对治疗良性前列腺增生患者术后尿控及性功能的影响

Effect of modified holmium laser enucleation of the prostate on postoperative urinary control and sexual function in elderly patients with benign prostatic hyperplasia

目的:探讨保留部分尿道粘膜前列腺钬激光剜除术对患者术后尿控、勃起功能及射精功能的影响。方法:回顾性分析2019年1月至2022年1月我院手术治疗的176例良性BPH患者,改良HoLEP手术80例,HoLEP手术96例。术前、术后分别统计相关临床资料。结果:术后3个月比较两组患者Qmax、IPSS、RUV及QOL较治疗前均有明显改善,差异有统计学意义(P<0.05);比较试验组与对照组QOL评分,具有显著性差异(P<0.05)。术后3个月,比较试验组和对照组尿失禁发生率(P<0.05),差异有统计学意义。术后6个月两组患者IIEF-5评分均较术前升高,差异有统计学意义(P<0.05);两组之间对照,无明显差异;试验组术后逆行射精发生率显著低于对照组(P<0.05)。结论:保留部分尿道粘膜HoLEP能够有效治疗BPH,在尿控方面有明显优势,对术后性功能整体恢复起到积极作用。

Objective:To investigate the impact of retaining part of the urethral mucosa on postoperative urinary control,erectile function,and ejaculatory function in patients undergoing holmium laser enucleation of the prostate(HoLEP)surgery.Methods:A retrospective analysis was conducted on 176 benign prostatic hyperplasia(BPH)patients who underwent surgical treatment at our hospital from January 2019 to January 2022,including 80 cases of modified HoLEP surgery and 96 cases of standard HoLEP surgery.Preoperative and postoperative clinical data were collected and analyzed.Results:At 3 months postoperatively,both groups showed significant improvement in maximum flow rate(Qmax),International Prostate Symptom Score(IPSS),residual urine volume(RUV),and quality of life(QOL)compared to pre-treatment values,with statistically significant differences(P<0.05).There was a significant difference in QOL scores between the experimental and control groups(P<0.05).At 3 months postoperatively,the incidence of urinary incontinence was significantly lower in the experimental group compared to the control group(P<0.05).At 6 months postoperatively,both groups showed a significant increase in International Index of Erectile Function-5(IIEF-5)scores compared to preoperative values(P<0.05),with no significant difference between the two groups.The incidence of retrograde ejaculation in the experimental group was significantly lower than that in the control group(P<0.05).Conclusions:Retaining part of the urethral mucosa in HoLEP surgery can effectively treat BPH,providing significant advantages in terms of urinary control and playing a positive role in overall postoperative sexual function recovery.