132例大体积良性前列腺增生行TUPKP术后3年随访结果

Bipolar transurethral plasmakinetic prostatectomy of the prostate in 132 consecutive patients with large gland: three-year follow-up results

目的:报告132例大体积良性前列腺增生行经尿道前列腺电切术(TUPKP)术后3年随访结果。方法:2010年3月-2013年5月,我科收治了132名连续入院的前列腺体积大于60 mL的前列腺增生患者,患者平均年龄为(64.55±4.03)岁,平均前列腺体积为(79.66±12.36) mL,IPSS评分为(21.41±4.64),QoL评分为(5.08±0.78),Q_(max)为(6.60±3.16) mL/s,PVR为(86.33±19.44) mL,PSA为(2.14±0.78) ng/mL,血红蛋白(136.68±2.61) g/L,血钠(142.55±1.67) mmol/L。132例患者均接受TUPKP,术后随访时间为第1、3、6个月及第1、2、3年。评价IPSS评分、QoL评分、Q_(max)、PVR、PSA水平变化。结果:手术时间为(78.83±17.41) min,手术切除组织的重量为(58.12±7.29) g,无TUR综合征发生,留置尿管时间为(69.00±17.99) h,住院时间为(117.00±17.99) h。血红蛋白及血钠的下降水平分别为(15.5±4.8) g/L、(1.57±0.38) mmol/L。术后至第3年随访时,患者Q_(max)为(22.34±3.1) mL/s、IPSS为2.90±1.60和QoL评分为1.12±0.60,与术前比较均有明显改善(P<0.01)。3年中6名患者(4.5%)接受再次手术。结论:TUPKP是治疗大体积前列腺增生安全有效的术式。

Objective: To report the result of 3-year follow-up of bipolar transurethral plasmakinetic prostatectomy(TUPKP) of the large prostate for the treatment of 132 case benign prostate hyperplasia(BPH).Methods: Between March 2010 and May 2013, 132 consecutive patients underwent TUPKP at our hospital were involved. All patients were assessed perioperatively and followed up at the end of 1, 3, 6, 12, 24, and 36 month(s) postoperatively. The parameters included International prostate symptom score(IPSS), quality of life(QoL) scores, maximum urinary flow rates(Qmax), postvoid residual urine(PVR) volume, and serum prostate-specific antigen(PSA) level were recorded.Results:Patients’ mean age was(64.55±4.03) years;prostate volume was(79.66±12.36) mL. Operative time was(78.83 ± 17.41) min, while resected prostate weight was(58.12 ± 7.29) g. Catheter time was(69.00±17.99) h and hospital stay was(117.00±17.99) h. Decreases of hemoglobin and sodium were(15.5±4.8) g/L and(1.57±0.38) mmol/L, respectively. A significant improvement occurred in Qmax as(22.34± 3.1) ml/s, IPSS as 2.90± 1.60, and QoL as 1.12± 0.60 after 3 years as compared with baseline(P<0.01). Among them, six patients in all patients(4.5%) required re-operation.Conclusion: TUPKP represents an effective surgical intervention for the treatment of bladder outlet obstruction for prostates with large sizes.