经尿道逆行腔内剜除双极等离子体电切治疗复发性前列腺增生

Transurethral enucleation and resection for treating recurrent benign prostatic hy- perplasia

目的介绍经尿道逆行腔内剜除双极等离子体电切治疗复发性前列腺增生的方法及其疗效。方法 2008年1月至2012年1月,78例经尿道前列腺电切术(TURP)术后复发的前列腺增生患者,行经尿道逆行腔内剜除双极等离子体电切治疗。比较本组患者本次手术前及术后6个月国际前列腺症状评分(IPSS)、生活质量(QOL)、最大尿流率(Qmax)、残余尿量(PVR)、前列腺特异抗原(PSA)等指标,评估其疗效。结果 78例患者术后2例出现暂时性尿失禁,6月后全部排尿正常;前尿道狭窄1例。患者术前和术后6个月平均IPSS、QOL、Qmax、PVR、PSA,分别为(21.9±4.5)分、(4.1±0.6)分、(6.2±2.9)mL/s、(93.6±50.1)mL、(3.58±2.76)ng/mL和(4.7±2.4)分、(0.8±0.5)分、(19.7±3.2)mL/s、(10.5±6.3)mL、(0.91±0.64)ng/mL,5个指标手术前后比较差异均有显著统计学意义(均P<0.01)。结论经尿道逆行腔内剜除双极等离子体电切治疗复发性前列腺增生方法可行、疗效确切。寻找外科包膜平面及前列腺剥离为本手术的关键。

Objective To introduce the method and the clinical efficacy of transurethral enucleation and resection of the prostate （TUERP） to treat recurrent benign prostatic hyperplasia （BPH）. Methods During Jan. 2008 to Jan. 2012, 78 BPH patients who had undergone transurethral resection of prostate （TURP） received TUERP for recurrent BPH. The international prostate symptom score （IPSS）, maximum urine flow rate （Qmax）, post void residual urine volume （PVR）, quality of life （QOL）, prostate specific antigen （PSA） before operation and 6 months after operation were compared. Results Of the 78 cases, 2 were complicated with temporary urinary incontinence, and 1 with anterior urethra stricture. The pre operation IPSS, QOL, Qmax, PVR, PSA were 21.9±4.5, 4.1±0.6,（6.2±2.9）mL/s,（93.6±50.1）mL,（3.58±2.76）ng/ mLrespectively; the post operation values were 4.7±2.4, 0.8±0.5, （19.7±3.2）mL/s、（10.5±6.3）mL、（0.91±0.64）ng/ mL. Significant statistics difference （P〈0.01） were observed between pre and post data. Conclusions TUERP is safe and effective in the treatment of recurrent BPH. The key to this surgery is looking for prostatic surgical capsule plane and prostate stripping.