经尿道等离子前列腺逆行剥离切除术治疗前列腺增生症

Plasmakinetic transurethral retrograde dissection of prostate for benign prostatic hyperplasia

目的探讨经尿道等离子体前列腺逆行剥离切除术治疗前列腺增生症(BPH)的临床疗效。方法采用经尿道等离子体前列腺逆行剥离切除术治疗BPH 120例。结果120例患者均手术成功,切除的前列腺组织28～120 g,平均45 g,手术时间30～150 min,平均70 min。术中出血量20～400 mL,平均80 mL,2例患者输血治疗。术中无包膜穿孔、电切综合征等并发症发生。术后膀胱冲洗时间4～72 h,平均26 h;拔除尿管时间2～7d,平均4 d;术后随访3～15个月,无尿失禁、尿道狭窄、再出血等并发症出现;测膀胱残余尿为0～20 mL,平均10 mL,IPSS下降至0～10分,平均6分。结论经尿道等离子体前列腺逆行剥离切除术治疗前列腺增生症效果好,手术时间短,并发症少,安全可靠。

[ Objective ] To investigate the efficacy of plasmakinetic transurethral retrograde dissection of prostate in the treatment of benign prostatic hyperplasia （BPH）. [Methods] Totally 120 patients with BPH were treated with plasmakinetic transurethral retrograde dissection in our hospital from November 2007 to November 2008. [ Results ] The operation was completed in all of the 120 cases. The reseeted prostate tissues weighed 28-120 g （mean, 45 g）. The operation time ranged from 30 to 150 minutes （mean, 70 minutes）, and the blood loss was 20 - 400 mL （mean, 80 mL）. Two cases needed blood transfusion. There were no such intraoperative complications as rupture of the prostatic capsule and TUR syndrome. Postoperative washing time of bladder was 4-72 h （mean, 26 h）, urethral catheter was removed in 2-7 d （mean, 4 d）. The patients were followed up for 3 - 15 months, during which residual urine decreased to 0 - 20 mL （mean, 10 mL） and 1PSS dropped to 0-10 （mean, 6）. No patient developed urinary incontinence, urethral stricture and postoperative hemorrhage. [ Conclusions] Plasmakinetic transurethral retrograde dissection of prostate is effective for the treatment of BPH with few complications.