钬激光剜除治疗前列腺增生术中保留控尿功能的技巧分析

Urinary continence after prostatectomy can be improved by modified HoLEP

目的创新应用最大限度保留控尿功能的钬激光剜除术治疗良性前列腺增生症BPH,并总结介绍其在尿控功能保护方面的技巧与疗效。方法 2014年1～12月,我科创新性开展最大限度保留控尿功能的钬激光剜除技术并应用于临床行隧道法剜除治疗BPH,共305例患者纳入本次研究,所有患者均由同一术者行此手术治疗。收集并记录所有患者术前一般情况,手术时间、输血情况、剜除前列腺组织质量、术后尿失禁及恢复情况等。结果所有患者均一次性完成手术,无中转开放手术病例,无输血患者,平均手术时间为（56.01±8.62）min,平均住院天数为（4.81±0.56）d,术后仅25例患者拔出导尿管后第一天出现急迫性尿失禁,无压力性尿失禁现象发生。随访3个月,所有患者均排尿通畅、无真性尿失禁及继发性出血现象。结论最大限度保留控尿功能的钬激光剜除术治疗BPH安全有效,术中技巧性最大限度保护控尿区域,控尿功能受影响极小、术后恢复快,不会造成永久性尿失禁现象。

Objective To explore the efficacy of modified holmium laser enucleation of the prostate（HoLEP）in the improvement of urinary continence after prostatectomy of benign prostate hyperplasia（BPH）.Methods During Jan.2014 and Dec.2014,305 BPH patients were treated with modified HoLEP.The operation time,blood transfusion,weight of the tissue enucleated,incidence of urinary incontinence and recovery were recorded.Results During the 6-month follow-up,all patients urinated fluently and had no incontinence or secondary hemorrhage.After operation,low urinary tract symptoms（LUTS）,including urgency,frequency and dysuresia were significantly improved.Conclusion Modified HoLEP is safe and effective for the treatment of BPH,and it can effectively improve urinary continence of BPH patients.