经尿道双极等离子电切术治疗良性前列腺增生的疗效及对患者尿流动力学、勃起功能的影响

The Effect of Transurethral Bipolar Plasma Resection in the Treatment of Benign Prostatic Hyperplasia and its Influence on Urodynamics and Erectile Function

目的探讨经尿道双极等离子电切术在良性前列腺增生(BPH)患者中的应用价值。方法选择2020年9月—2022年8月本院收治的84例BPH患者为研究对象,按随机数字表法分为两组。对照组(n=42)采用经尿道前列腺电切术治疗,观察组(n=42)采用经尿道双极等离子电切术治疗,两组术后均随访3个月。对比两组患者的临床疗效、症状严重程度、尿流动力学、勃起功能及术后并发症发生情况。结果观察组的治疗总有效率为95.24%,高于对照组的78.57%,差异有统计学意义(P<0.05)。术后3个月,观察组的症状严重程度轻于对照组,差异有统计学意义(P<0.05)。术后3个月,观察组的残余尿量为(31.17±3.42)mL,少于对照组的(38.51±3.26)mL,最大尿道闭合压、最大尿流率分别为(43.26±4.28)cmH2O、(19.27±1.50)mL/s,均高于对照组的(37.92±4.11)cmH2O、(15.64±1.38)mL/s,组间差异有统计学意义(P<0.05)。术后3个月,观察组的国际勃起功能指数-5评分为(19.89±1.43)分,高于对照组的(16.07±1.75)分,差异有统计学意义(P<0.05)。观察组的术后并发症发生率为4.76%,低于对照组的19.05%,差异有统计学意义(P<0.05)。结论经尿道双极等离子电切术可促进BPH患者的症状恢复,改善尿流动力学,减轻对术后勃起功能的影响,且术后并发症较少,临床应用价值更高。

Objective To explore the application value of transurethral bipolar plasma resection in patients with benign prostatic hyperplasia(BPH).Methods 84 BPH patients admitted to the hospital from September 2020 to August 2022 were selected as the research objects and were divided into two groups according to random number table method.The control group(n=42)was treated with transurethral resection of prostate,and the observation group(n=42)was treated with transurethral bipolar plasma resection.Both groups were followed up for 3 months.The clinical efficacy,severity of symptoms,urodynamics,erectile function and postoperative complications were compared between the two groups.Results The total effective rate of the observation group was 95.24%,higher than 78.57%of the control group,the difference was statistically significant(P<0.05).3 months after operation,the severity of symptoms in the observation group was less than that in the control group,and the difference was statistically significant(P<0.05).3 months after operation,the post-voiding residual volume of the observation group was(31.17±3.42)mL,which was less than(38.51±3.26)mL of the control group,the maximum urethral closure pressure and maximum urine flow rate were(43.26±4.28)cmH2O and(19.27±1.50)mL/s,respectively,which were higher than(37.92±4.11)cmH2O and(15.64±1.38)mL/s in the control group,the differences between the groups were statistically significant(P<0.05).3 months after operation,the international index of erectile function-5 score of the observation group was(19.89±1.43)points,which was higher than(16.07±1.75)points of the control group,and the difference was statistically significant(P<0.05).The incidence of postoperative complications in the observation group was 4.76%,lower than 19.05%in the control group,and the difference was statistically significant(P<0.05).Conclusion Transurethral bipolar plasma resection can promote the recovery of symptoms in BPH patients,improve urinary flow dynamics,reduce the impact on postoperative erectile function,and less postoperative complications,and has higher clinical application value.