经尿道电切与气化切割和激光治疗前列腺增生症的疗效比较

Evaluation of transurethral resection, vaporization and contact laser prostatectomy for the treatment of BPH

目的 :比较经尿道电切前列腺术 (TURP) ,经尿道前列腺气化切除术 (TUVP)及经尿道接触式激光前列腺切除术 (TULP)的治疗效果。方法 :在 30 0 0例前列腺增生症患者中 ,按三种术式各随机抽取 2 0例术前条件具有可比性的患者 ,进行疗效比较。结果 :3种术式患者手术前后前列腺症状评分 (IPSS)、生活质量评分(QOL)、最大尿流率 (MFR)、剩余尿 (PVR)比较均得到显著改善 (P <0 .0 1) ,3组之间相比差异无显著性意义(P >0 .0 5 )。手术时间 :TUVP及TURP组明显短于TULP组 (P <0 .0 1) ,术中失血量及术后置管时间 :TUVP及TULP组明显少于TURP组 (P <0 .0 1)。TURP组术后继发感染、出血、暂时性尿失禁发生率少于TUVP及TULP组。结论 :3种术式治疗效果相同 ;TUVP操作简单、安全 ,对初学者来说尤其适宜 ;

Purpose:To evaluate the effect of transurethral resection of prostate (TURP), transurethral vaporization of prostate (TUVP) and transurethral contact laser prostatectomy (TULP) for the treatment of symptomatic BPH.Methods:Sixty patients with symptomatic BPH were randomly put in the groups of TURP, TUVP or TULP.Results:Postoperatively, the IPSS, QOL, MFR and PVR of all the cases were significantly improved (P< 0.01 ), and there was no significant difference among the three groups. The duration of the procedure in the TUVP and TURP groups was significantly shorter than that in the TULP group (P< 0.01 ). The blood loss during the operation in the TUVP and TULP groups was significantly less than that in the TURP group (P< 0.01 ). The indwelling catheter time in the TUVP and TULP groups was significantly shorter than that in the TURP group (P< 0.01 ). The secondary bleeding and infection in the TURP group was less than that in the TUVP and TULP groups.Conclusions:TUVP and TULP are as effective as TURP for the treatment of symptomatic BPH. TUVP is easy to handle and safe for beginners. TURP is still a 'golden standard ' for the treatment of symptomatic BPH.