经尿道前列腺钬激光剜除术和经尿道前列腺电切术对良性前列腺增生患者尿流率残余尿量和性功能的影响

Influence of HoLEP and TURP on Urinary Flow Rate Residual Urine Volume and Sexual Function in Patients with Benign Prostatic Hyperplasia

目的:探讨经尿道前列腺钬激光剜除术(holmium laser enucleation of the prostate,HoLEP)和经尿道前列腺电切术(transurethral resection of prostate,TURP)对良性前列腺增生患者尿流率、残余尿量和性功能的影响。方法:回顾性分析2020年5月至2022年4月256例良性前列腺增生患者,分为HoLEP组126例和TURP组130例。比较两组患者尿流率、残余尿量和性功能。结果:术后,两组最大尿流率、国际勃起功能指数(IIEF-5)均高于术前,残余尿量、国际前列腺症状评分(IPSS)、生活质量评分(QOL)均低于术前(P<0.05)。HoLEP组最大尿流率、残余尿量、IIEF-5评分、IPSS评分、QOL评分手术前后差值均高于TURP组(P<0.05)。术后HoLEP组的逆行射精发生率低于TURP组(P<0.05)。结论:相比TURP,前列腺增生采用HoLEP治疗明显提高尿流率,减少残余尿量,降低勃起功能障碍和逆行射精,提高性功能,手术微创,安全性高。

Objective:To investigate the influence of HoLEP and TURP on urinary flow rate,residual urine volume and sexual function in patients with BPH.Methods:This study retrospectively reviewed 256 patients with BPH admitted to the hospital between May 2020 and April 2022.Patients treated with HoLEP and TURP were defined as HoLEP group(n=126)and TURP group(n=130).Comparison was made between groups in terms of urinary flow rate,residual urine volume,and sexual function.Results:After operation,the maximum flow rate and international erectile function index(IIEF-5)of both groups were higher than before operation,while residual urine volume,international prostate symptom score(IPSS),and quality of life score(QOL)were lower than before operation(P<0.05).The difference in maximum flow rate,residual urine volume,IIEF-5 score,IPSS score,and QOL score before and after operation in the HoLEP group was higher than that in the TURP group(P<0.05).The incidence of retrograde ejaculation after operation in the HoLEP group was lower than that in the TURP group(P<0.05).Conclusion:Compared with TURP,HoLEP can improve urine flow rate and reduce residual urine volume,reduce erectile dysfunction and retrograde ejaculation,and improve sexual function in patients with BPH.It is minimally invasive,with high security.