钬激光前列腺剜除术对复发性前列腺增生治疗的临床分析

Clinical Analysis of HoLEP for Treating Recurrent Benign Prostatic Hyperplasia

目的探讨经过不同手术方式治疗后复发良性前列腺增生症(Benign prostatic hyperplasia,BPH)患者接受钬激光前列腺剜除术(Holmium laser enucleation of the prostate,HoLEP)的临床疗效和安全性。方法回顾性分析2015年2月至2016年6月,复发BPH患者42例的临床资料,所有患者均实行HoLEP手术,手术均顺利完成,术后对手术时间、并发症及术后疗效做出评估。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(33.1±7.2)min,平均住院天数为(3.3±0.8)d。术后随访6个月,所有患者均排尿通畅,有1例暂时性尿失禁,2例尿道狭窄发生。术后前列腺症状评分、生活质量评分、最大尿流率得到明显改善,与术前相比具有统计学意义(P<0.05)。结论 HoLEP对初次治疗复发BPH患者不仅在技术上可行,而且安全有效;HoLEP术后尿道狭窄有一定发生率,需要进一步重视。

Objective To investigate the effect and safety of HoLEP for treating recurrent benign prostate hyperplasia.Methods During Feb. 2015 to Jun. 2016, 42 recurrent BPH patients were retrospectively analysed. All patients were treated with HoLEP successfully. After surgery we estimated the operation time, effect and complication.Results All procedures were successfully performed in only one attampt. No cases needed blood transfusion and were converted to open operation. The average operation time was（33.1 ±7. 2）min and hospitalizing time was（3. 3 ±0. 2）day. After six months, there were only one patients was complicated with temporary urinary incontinence and 2 patients with anterior urethra stricture. The IPSS,QOL and Qmax were significantly improved, which had statistically significant difference with those before operation（P〈0. 05）.Conclusions HoLEP is a feasible method with good clinical efficacy and safety for treating recurrent benign prostate hyperplasia. After HoLEP, there are possible inciclence for urethral stricture, which need further search.