腔内分部剜除术与TUERP在治疗大体积前列腺增生的疗效比较

Effectiveness of Divided Transurethral Enucleation of the Prostate vs Transurethral Enucleative Resection of Prostate in Large Benign Prostatic Hyperplasia

目的评价腔内分部剜除术与经尿道前列腺剜除术（TUERP）治疗体积〉100 mL的前列腺增生症（BPH）的有效性及安全性。方法回顾性分析208例体积〉100 mL、采用腔内分部剜除术（102例）和TUERP（106例）的BPH患者临床资料,比较2组患者的年龄、体质量指数、前列腺体积、血红蛋白（HB）水平、残尿量（RUV）、最大尿流率（Qmax）、生活质量评分（QOL）、国际前列腺症状评分（IPSS）、围手术期情况,以及术后3,6,12月患者IPPS评分、Qmax、RUV、QOL、逆行射精、性功能、尿失禁情况等指标。结果2组患者术后均随访14月（12-24月）。2组术后IPSS评分、Qmax、RUV、QOL差别无统计学意义（P〉0.05）;术后早期分部剜除术组尿失禁发生率低于TUERP组（P〈0.01）,但是在逆行射精方面,分部剜除术组在术后3,6,12月随访中优于TUERP组。结论分部剜除术治疗体积〉100mL的BPH的有效性及安全性优于TUERP。

Objective To compare the therapeutic efficacy of divided transurethral enucleation of the prostate with transurethral enucleative resection of prostate on large benign prostate hyperplasia（vol- ume〉100 mL）. Methods A set of review dataon 208 large volume prostate patientsfrom January 2010 to January 2015 was used. The clinical cases respectively were divided into transurethral enucleation of the prostate （102 cases） and TUERP （106 cases）. In the two groups the following data were analyzed. age, body mass index, prostate volume, HB level, residual urine volume,large urinary flow rate, quality of life score, perioperative International Prostate Symptom Score （IPSS）, perioperative conditions were re- corded. 3,6, 12 montes,patients IPPS score, Qmax, RUV, QOL, retrograde ejaculation, sexual func- tion, incontinence and other indicators situation were recorded. Results Patients were followed up for 12-24 months, and median follow-up time was 14 months. After 3, 6 and 12-month follow-up process, both sets of postoperative IPSS score, Qmax, RUV, QOL showed no significant difference. Early post- surgery, in the divided enucleation group, the urinary incontinence was lower than that in TUERP group. However, there were no significant difference in long-term urinary incontinence. In retrograde ejacula- tion connection, the divided enucleation group was better than TUERP group after 3, 6, 12-month follow- ups. Conclusions Divided transurethral enucleation forthe volume〉100 mL BPH has a better efficacy and safety than TUERP.