经尿道摩西钬激光治疗大体积前列腺增生的初步体会

Preliminary experiences of moses laser enucleation of the prostate(MoLEP)in the treatment of massive prostatic hyperplasia

目的研究经尿道摩西钬激光前列腺剜除术(MoLEP)对大体积前列腺增生(≥80 ml)的安全性和疗效。方法回顾2019年4月至2019年10月海军军医大学公利医院接诊的大体积前列腺增生患者共计37例,其中采用MoLEP治疗患者19例,采用经尿道钬激光前列腺剜除术(HoLEP)患者18例。对比两组患者在手术相关指标及并发症的发生率,判断MoLEP对大体积前列腺增生的疗效。结果MoLEP组与HoLEP组在术后膀胱冲洗时间(0.87±0.23)vs(1.17±0.38)d、术后住院时间(3.53±0.84)vs(4.22±1.22)d、血红蛋白下降量(18.89±7.70)vs(17.67±6.73)g/L等差异有统计学意义(P<0.05);在术后3个月IPSS、QOL、RUV、Qmax方面,两组均优于术前,但两组之间对比差异无统计学意义(P>0.05);在术后尿路感染、排尿困难、尿失禁等并发症方面差异亦无统计学意义(P>0.05);两组均无电切综合征及输血病例。结论MoLEP与HoLEP疗效相近,但术后膀胱冲洗时间、留置导尿时间、住院时间明显缩短,术中出血量更少,具有明显优势。

Objective To analyze the clinical efficacy and safety of transurethral MoLEP for massive prostatic hyperplasia(BPH)≥80 ml.Methods A total of 37 patients with BPH who were admitted to Gongli Hospital of Naval Military Medical University from April 2019 to October 2019 were reviewed.Among them,19 patients were treated with moses laser enucleation of the prostate(MoLEP)and 18 patients were treated with holmium laser enucleation of the prostate(HoLEP).Statistics and comparison of the efficacy and the incidence of complications between the two groups of patients to determine the efficacy of MoLEP on large-volume BPH.Results There were significant differences between the two groups in terms of postoperative bladder flushing time(0.87±0.23)vs(1.17±0.38)d,length of hospital stay(3.53±0.84)vs(4.22±1.22)d,and hemoglobin reduction(18.89±7.70)vs(17.67±6.73)g/L(P<0.05);In terms of IPSS,QOL,RUV and Qmax,at 3 months after operation,both groups were improved before surgery,there was no significant difference between the two groups(P>0.05).There were also no significant differences in complications such as postoperative urinary tract infection,dysuria,and urinary incontinence(P>0.05);there were no transurethral resection syndrome and blood transfusion in both groups.Conclusions MoLEP and HoLEP have similar effects,but in MoLEP group,the postoperative bladder irrigation time,indwelling catheterization time,and hospitalization time are significantly shortened,and the intraoperative blood loss is less,which has obvious advantages.