铥激光前列腺剜除术治疗良性前列腺增生的效果及对性功能的影响

Effects of thulium laser enucleation of the prostate in the treatment of benign prostatic hyperplasia and its influence on sexual function

目的比较铥激光前列腺剜除术(ThuLEP)与经尿道前列腺电切术(TURP)治疗良性前列腺增生(BPH)的效果及对性功能的影响。方法选取2018年12月至2020年12月西昌市人民医院收治的78例BPH患者作为研究对象,进行回顾性分析。根据术式不同分为ThuLEP组(n=42,采用ThuLEP治疗)与TURP组(n=36,采用TURP治疗)。比较两组手术情况、术前及术后3个月排尿参数[最大尿流率(Qmax)、残余尿量(PVR)]、疾病恢复情况、性功能,比较两组并发症发生情况。结果两组手术时间、术中出血量比较,差异无统计学意义(P>0.05);ThuLEP组术后膀胱冲洗时间、尿管留置时间明显短于TURP组,差异具有统计学意义(P<0.05)。术后3个月,两组Qmax均较术前显著上升,PVR均较术前显著下降,差异具有统计学意义(P<0.05);术前及术后3个月,两组间Qmax、PVR比较,差异无统计学意义(P>0.05)。术后3个月,两组男性性健康问卷-射精功能障碍(MSHQ-EJD)评分均较术前显著下降,差异具有统计学意义(P<0.05),两组国际勃起功能指数-5(IIEF-5)评分与术前比较,差异无统计学意义(P>0.05);术前及术后3个月,两组间IIEF-5评分、MSHQ-EJD评分比较,差异无统计学意义(P>0.05)。两组并发症发生情况比较,差异无统计学意义(P>0.05)。结论ThuLEP与TURP治疗BPH均具有良好疗效,能够改善患者的临床症状及排尿情况,但ThuLEP更利于患者术后恢复,且勃起功能恢复得更好。

Objective To compare the effects of thulium laser enucleation of the prostate(ThuLEP)and transurethral resection of the prostate(TURP)in the treatment of benign prostatic hyperplasia(BPH)and their influence on sexual function.Methods 78 patients with BPH admitted to Xichang People′s Hospital between December 2018 and December 2020 were selected as the research subjects for retrospective analysis,and were divided into ThuLEP group(n=42,ThuLEP)and TURP group(n=36,TURP)according to different surgical procedures.The surgical status,urination parameters[maximum urine flow rate(Qmax),post-voiding residual(PVR)],disease recovery status and sexual function before surgery and at 3 months after surgery and occurrence of complications were compared between the two groups.Results There were no significant differences in the surgical time and intraoperative blood loss between the two groups(P>0.05).The postoperative bladder irrigation time and catheter indwelling time in ThuLEP group were significantly shorter than those in TURP group(P<0.05).At 3 months after surgery,the Qmax level of the two groups was increased significantly compared to before surgery,while the PVR level was significantly decreased compared to before surgery(P<0.05);there were no significant differences in Qmax and PVR between the two groups before surgery and at 3 months after surgery(P>0.05).At 3 months after surgery,the male sexual health questionnaire-ejaculation disorder(MSHQ-EJD)score of the two groups at 3 months after surgery was significantly reduced compared with that before surgery(P<0.05),and the international index of erectile function-5(IIEF-5)score of the two groups was not significantly different from that before surgery(P>0.05).Before surgery and at 3 months after surgery,there were no statistical differences in the scores of IIEF-5 and MSHQ-EJD between the two groups(P>0.05).The differences in the occurrence of complications between the two groups were not statistically significant(P>0.05).Conclusions Both ThuLEP and TURP have good curative effects in the treatment of BPH and can improve the symptoms and urination of patients,but ThuLEP is more conducive to the postoperative recovery of patients,and the recovery of erectile function is better.