改良经尿道前列腺先切后剜术治疗良性前列腺增生的疗效分析(附25例报告)

Transurethral Resection and Enucleation of the Prostate for Treatment of Prostatic Hyperplasia:A Report of 25 Cases

目的探讨改良经尿道双极等离子前列腺先切后剜术治疗良性前列腺增生的疗效。方法回顾性分析2017年5月至2018年3月本单位行改良经尿道双极等离子前列腺先切后剜术治疗25例BPH患者的临床资料及手术效果。结果 25例手术均获成功,手术时间50～120分钟,平均手术时间(82. 6±16. 3)分钟;术中出血量约50～200ml;切除腺体50～130g;术后留置尿管48～72小时;膀胱冲洗时间12～36小时;住院时间5～10天。所有患者均未出现压力性尿失禁现象,术后随访3～6个月,无尿道狭窄,无尿失禁,术后3个月国际前列腺症状评分(international prostate symptom score,IPSS)(6. 4±3. 3)分,生活质量(quality of life,QoL)评分小于3分,术后残余尿均为阴性。结论改良经尿道前列腺先切后剜术治疗良性前列腺增生安全可行,操作简化,疗效满意。

Objective To investigate the efficacy of transurethral bipolar plasmakinetic resection followed by enucleation for the treatment of prostatic hyperplasia. Methods The clinical data and surgical results of 25 BPH patients treated by transurethral enucleation of prostate in department of urology of Ji＇an first people＇s hospital from may 2017 to March 2018 were retrospectively analyzed. Results All 25 cases were successfully operated, the operation time ranged from 50 to 120 minutes, （82.6 ±16.3） minutes in average. The intraoperative estimated blood loss ranged from 50 to 200 ml. 50 to 130 gram of glands were removed; The catheteration time ranged from 48 to 72h post operatively. Bladder irrigation time ranged from 12 to 36 h. The hospital stay was 5 to 10 days. No stress urinary incontinence occured in all patients. After 3 to 6 months of follow - up, there was no observation of urethral stricture or urinary incontinence. 3 months after surgery, The average IPSS （international prostate symptom score） score was （6.4 ± 3.3 ）, the average QoL （ quality of life） score was less than 3 points, and the residual urine was negative. Conclusions The transurethral bipolar plasmakinetic resection followed by enucleation is safe and feasible for the treatment of prostatic hypeqolasia, the operation is simplified and the curative effect is satisfactory.