TURP和选择性绿激光汽化术治疗良性前列腺增生对性激素及勃起功能的影响

Effects of TURP and greenlight photoselective vaporization of prostate on sex hormones and erectile function in benign prostatic hyperplasia

目的:探讨经尿道前列腺电切术(TURP)和选择性绿激光汽化术(PVP)治疗良性前列腺增生(BPH)对患者性激素水平及勃起功能的影响。方法:选取203例BPH患者为研究对象,根据手术方式不同分为TURP组(n=98)和PVP组(n=105)。比较两组患者手术一般情况(手术时间、术中失血量、留置尿管时间和住院时间)、手术前后性激素[雌二醇(E_(2))、睾酮(T)水平和雌雄激素比例(E_(2)/T)]、勃起功能[国际勃起功能指数(IIEF-5)评分和勃起硬度分级(EHS)评分]、生活质量[(QOL)评分]及并发症发生情况。结果:与TURP组相比,PVP组尿管留置时间及住院时间较短,术中失血量较少(P<0.05);术后1周,两组患者E_(2)、T水平、E_(2)/T及QOL评分均降低,且PVP组低于TURP组(P<0.05);IIEF-5评分及EHS评分均升高,且PVP高于TURP组(P<0.05)。PVP组术后并发症总发生率低于TURP组(6.67%vs.15.31%,P<0.05)。结论:相比于TURP,PVP治疗BPH更能能有效改善患者性激素水平、勃起功能及生活质量,且具有创伤小、术后并发症少等优势,值得临床推广。

Objective:To explore the effects of transurethral resection of the prostate(TURP)and greenlight photoselective vaporization of prostate(PVP)on levels of sex hormones and erectile function in benign prostatic hyperplasia(BPH).Methods:203 patients with BPH were selected as the study subjects and divided into TURP group(n=98)and PVP group(n=105)according to different surgical methods.The general condition of surgery(surgical time,intraoperative blood loss,indwelling catheter time,and hospitalization time),preoperative and postoperative sex hormone levels[stradiol(E_(2))and testosterone(T),ratio of E_(2) to T(E_(2)/T)],erectile function[scores of international index of erectile function 5(IIEF-5)and Erectile Hardness Score(EHS)],quality of life(QOL),and complications were compared between the two groups.Results:Compared with TURP group,catheter indwelling time and hospitalization time were shorter in PVP group,and intraoperative blood loss was less(P<0.05).Compared with those before surgery,levels of E_(2),T,E_(2)/T and QOL scores were decreased,and the PVP group was lower than the TURP group(P<0.05).The scores of IIEF-5 and EHS were increased at 1 week after surgery in both groups,and the the PVP group was higher than the TURP group(P<0.05).The total incidence of postoperative complications in PVP group was lower than that in TURP group(6.67%vs.15.31%,P<0.05).Conclusion:Compared with TURP,PVP can significantly improve levels of sex hormones,erectile function and quality of life in BPH patients,it has the advantages such as little trauma and few postoperative complications.It is worthy of clinical promotion.