经尿道接触式激光、电极汽化及电汽化切割治疗前列腺增生的效果比较(附758例报告)

An evaluation of transurethral contact laser prostatectomy and vaporization or electrovaporization ablation prostatectomy for the treatment of symptomatic BPH

目的 比较经尿道接触式激光前列腺术 (TULP)、经尿道电极汽化前列腺术 (TVP)和经尿道电汽化切割前列腺术 (TUEVAP)对良性前列腺增生症 (BPH)的治疗效果。 方法 对 75 8例BPH患者采用 3种术式 ,其中行TULP者 388例 ,行TVP者 2 0 3例 ,行TUEVAP者 16 7例。 结果 患者手术前后国际前列腺症状评分 (IPSS)、生活质量评分 (QOL)、最大尿流率 (MFR)、剩余尿(PVR)比较均得到显著改善 (P <0 .0 1)。 3组术后客观症状的改善情况分别与另一组经尿道前列腺电切术 (TURP)组相比差别无显著性意义 (P >0 .0 5 ) ;TULP组术后留置导尿管时间、尿路刺激症状、血尿及急性附睾炎的发病率明显高于其他组 (P <0 .0 1)。 结论 TULP、TVP及TUEVAP治疗BPH均可达到与TURP相似的主、客观症状改善 ;术后并发症明显少于TURP ;其中TUEVAP操作简单 ,去除腺体量大 ,恢复快 ,近期疗效满意 ,有良好的应用前景。

Objective To evaluate transurethral contact laser prostatectomy and vaporization or electrovaporisation ablation prostatectomy for the treatment of symptomatic BPH. Methods Transurethral contact laser prostatectomy has been carried out for 388 cases of symptomatic BPH,transurethral vaporization prostatectomy for 203 and transurethral electrovaporization ablation prostatectomy for 167.The therapeutic results were evaluated and compared. Results IPSS score, QOL, Qmax and PVR were significantly improved after either of the procedures and the therapeutic results being comparable to TURP.No significant difference in the improvement of subjective symptoms and objective signs has been noted with the different procedures.The mean indwelling catheter time was longer in the transurethral contact laser prostatectomy group and the postoperative hematuria and irritative symptoms lasted longer and the occurrence of acute epididymitis more. Conclusions Transurethral electro vaporization ablation prostatectomy,transurethral vaporization prostatectomy and transurethral contact laser prostatectomy are as effective as TURP for the treatment of symptomatic BPH.As transurethral electrovaporization ablation prostatectomy yields the least adverse side effect it is therefore recommanded for the treatment of symptomatic BPH.