经尿道前列腺电切、双极等离子电切与2μm激光治疗前列腺增生术后并发尿道狭窄的相关因素分析

Study on urethral stricture after transurethral resection of the prostate, plasma kinetic resection of the prostate and 2 μm continuous-wave thulium laser for the treatment of benign prostatic hyperplasia

目的分析经尿道前列腺电切术(TURP)、双极等离子电切术(PKRP)与2μm激光前列腺切除术治疗前列腺增生(BPH)后影响尿道狭窄发生的相关临床因素。方法对44例接受TURP患者,28例接受PKRP患者及22例接受2μm激光治疗的BPH患者的临床资料进行回顾性研究,对比三组术式的临床效果,分析手术时间、术后膀胱冲洗时间、留置尿管时间、住院时间、术后尿路感染等与尿道狭窄发生率的关系。结果两组术前一般情况比较无统计学差异(P>0.05),手术时间、留置尿管时间、住院时间、术后尿路感染方面,PKRP组、激光组均明显优于TURP组(P<0.05)。术后6个月中,TURP组有9例发生尿道狭窄(20.5%),而PKRP与激光组则仅有1例,后两组尿道狭窄的发生率明显低于TURP组(P<0.05)。Logistic回归分析,留置尿管时间是TURP术后尿道狭窄的主要影响因素,PKRP与激光组中各指标对尿道狭窄的发生无明显的影响作用。结论 2μm激光与PKRP在治疗BPH方面具有相似的手术效果及预后,二者在术后尿道狭窄发生率方面明显低于TURP,有良好的应用前景。

Objective To study the effects of clinical nomograms on urethral stricture after transurethral resection of the prostate （TURP）, plasma kinetic resection of the prostate （PKRP） and 21μm continuous-wave thulium laser for the treatment of benign prostatic hyperplasia （BPH）. Methods Clinical data of 44 TURP cases, 28 PKRP cases and 22 2μm laser cases were analyzed retrospectively, clinical efficacy was compared among the three groups and correlation between incidence of urethral stricture and clinical factors including operative time, bladder irrigating time, catheter detain time, hospitalization time and quantity of WBC in urine was evaluated 6 months postoperativly. Results No significant difference of preoperative factors were found among the three groups （P〉0.05）. Operative time, catheter detain time, hospitalization time and quantity of WBC in urine 6 months after operation were improved in PKRP and 2 μm laser groups while compare to TURP group （P〈0.05）. Urethral stricture occurred in 9 cases in TURP group when only one case in PKRP group and 2 μm laser group respectively 6 months after surgery （P〉0.05）. Catheter detain time was the main cause of urethral stricture after TURP, otherwise no factors exert effect on urethral stricture after PKRP with analysis of Logistic. Conclusion 2 μm Continuous-wave Thulium Laser and PKRP has lower incidence of urethral stricture than TURP, and may have a promising future.