3D打印激光工作鞘在绿激光前列腺汽化术中的安全性和有效性

Safety and Efficacy of 3D-printed Laser Working Shealth Applying in Photoselective Vaporization of the Prostate

目的探讨3D打印制作激光工作鞘在经尿道绿激光前列腺汽化术中的安全性和有效性。方法选择2019年9~11月50例前列腺增生,前列腺体积25~75 ml,平均45 ml,采用3D打印制作的激光工作鞘连接F21膀胱镜外鞘行经尿道绿激光前列腺汽化术。结果50例手术均成功完成,手术时间30~95 min,平均56 min,术中出血<50 ml。术后膀胱冲洗时间8~36 h,平均17 h。术后2~4天拔除尿管,无尿外渗、尿失禁、排尿困难。术后6个月国际前列腺症状评分(International Prostate Symptom Score,IPSS)由术前(23.5±4.7)分降至(4.7±1.6)分(t=28.506,P=0.000),最大尿流率(Qmax)由术前(6.3±3.3)ml/s提高至(21.7±4.7)ml/s(t=-20.754,P=0.000),均无尿道狭窄、排尿困难、逆行射精、膀胱颈挛缩等发生。结论3D打印制作激光工作鞘连接F21膀胱镜外鞘的绿激光前列腺汽化术治疗前列腺增生微创、安全、有效。

Objective To evaluate the safety and efficacy of 3D-printed laser working shealth applying in the photoselective vaporization of the prostate(PVP).Methods From September 2019 to November 2019,50 cases of benign prostate hyperplasia(BPH)were prospectively collected.The volume of the prostate was 25-75 ml(mean,45 ml).PVP was performed using a 3D-printed laser working sheath which connected with the outer sheath of F21 cystoscope.Results All the 50 cases of BPH were effectively treated with PVP in the mean time of 56 minutes(range,30-95 minutes).The intraoperative blood loss was<50 ml.The mean postoperative bladder irrigation time was 17 hours(range,8-36 hours).The urethral catheter was withdrawn at 2-4 days.No urinary infiltration or incontinence occurred.All the cases on re-examination after 6 months showed that significantly decreased International Prostate Symptom Score(IPSS)(from 23.5±4.7 to 4.7±1.6,t=28.506,P=0.000)and increased Qmax(from 6.3±3.3 ml/s to 21.7±4.7 ml/s,t=-20.754,P=0.000).No patients had urinary stricture,dysurine,retrograde ejaculation,and bladder neck contracture.Conclusion 3D-printed laser working shealth connecting with the outer sheath of F21 cystoscope is safe,effective and minimally invasive for the treatment of BPH.