Objectives:To compare the depth of thermal necrosis after use of bipolar resection and vaporization technique comparing intra-individually bipolar loop and bipolar button electrodes.Methods:Transurethral resection and...Objectives:To compare the depth of thermal necrosis after use of bipolar resection and vaporization technique comparing intra-individually bipolar loop and bipolar button electrodes.Methods:Transurethral resection and vaporization of the prostate was performed in 55 male patients(260 specimens in total).In a standardized procedure,a bipolar resection loop was used for resection,and a bipolar button electrode was used for vaporization.Both electrodes were applied in each patient,either in the left or in the right lateral lobe.The depth of necrotic zones in the resected or vaporized tissue of each patient was measured in a standardized way by light microscopy.Results:The mean depth with standard deviation of thermal injury caused by the loop electrode was 0.0495±0.0274 mm.The vaporization electrode caused a mean thermal depth with standard deviation of 0.0477±0.0276 mm.The mean difference of necrosis zone depths between the two types of electrodes(PlasmaButtoneresection loop)was 0.0018 mm(p=0.691).Conclusion:For the first time,we present directly measured values of the absolute necrosis zone depth after application of plasma in the transurethral treatment of benign prostatic hyperplasia.The measured values were lower than in all other transurethral procedures.Standardized procedures of measurement and evaluation allow a statistically significant statement that the low necrosis depth in bipolar procedures is independent of the applied electrodes.展开更多
In the past 2 decades,endoscopic enucleation of the prostate has become a safe and effective surgical treatment for benign prostatic hyperplasia(BPH),with comparable outcomes to traditional surgeries.Transurethral vap...In the past 2 decades,endoscopic enucleation of the prostate has become a safe and effective surgical treatment for benign prostatic hyperplasia(BPH),with comparable outcomes to traditional surgeries.Transurethral vapor enucleation and resection of the prostate(TVERP),transurethral vapor enucleation of the prostate(TVEP),and ultrasound-navigated TVEP(US-TVEP)are new,innovative endoscopic enucleation procedures.These procedures are named Xie’s Prostate Enucleations(Xie’s Procedures for short).Current clinical data indicate that Xie’s Procedures are safe and effective treatment options for patients with BPH,especially for patients with larger prostates.Further prospective,randomized clinical trials compared with traditional transurethral resection of prostate(TURP)are still needed.展开更多
目的:对比经尿道等离子体前列腺汽化剜除术(transurethral plasmakinetic vaporization enucleation of the prostate,TPVEP)与经尿道前列腺电切术(transurethral resection of the prostate,TURP)对良性前列腺增生患者性功能的影响。方...目的:对比经尿道等离子体前列腺汽化剜除术(transurethral plasmakinetic vaporization enucleation of the prostate,TPVEP)与经尿道前列腺电切术(transurethral resection of the prostate,TURP)对良性前列腺增生患者性功能的影响。方法:将2012年12月至2014年12月于我院接受手术治疗的92例患者按自愿原则分为TPVEP组与TURP组,术前1d及出院时检查患者生活质量指数QOL、前列腺症状评分IPSS、最大尿流量Qmax及残余尿量RUV,记录手术时间、术中出血量及术中并发症发生率,随访期调查阴茎勃起功能障碍ED与逆行射精(RE)的发生率。结果:(1)两组的手术时间不存在显著差异(P>0.05),而TPVEP组切除腺体的重量大于TURP组,术中出血量、术后置管时间、住院时间均要明显低于TURP组(P<0.01),且其术中、术后并发症发生率也显著低于TURP组(P<0.05);(2)与术前相比,两组患者术后的QOL、IPSS、RUV均显著下降,Qmax显著升高,差异均有统计学意义(P<0.05)。除IPSS评分TPVEP组显著低于TURP组外,其余指标组间对比均无统计学差异(P>0.05);(3)术后6个月,TPVEP组的ED发生率及RE发生率均显著低于TURP组(P<0.05)。术后9个月,两组的发生率均有一定程度的下降,但TPVEP组仍旧显著低于TURP组(P<0.05)。结论:TPVEP术综合了剜除术与等离子汽化系统的优点,具有切除彻底、创伤小、恢复快、疗效确切、并发症少等优点,可显著改善患者尿动力学指标,促进前列腺功能与性功能的恢复。展开更多
目的对比经尿道直出光纤绿激光前列腺锐性剜除术(green light top-firing,sharp enucleation of the prostate,GTSEP)和绿激光选择性光汽化术(photoselective vaporisation of the prostate,PVP)治疗良性前列腺增生症(benign prostatic ...目的对比经尿道直出光纤绿激光前列腺锐性剜除术(green light top-firing,sharp enucleation of the prostate,GTSEP)和绿激光选择性光汽化术(photoselective vaporisation of the prostate,PVP)治疗良性前列腺增生症(benign prostatic hyperplasia,BPH)患者的有效性和安全性。方法选取2018年6月至2019年4月在本院诊治的154例BPH患者,按随机数字表法分为两组,每组77例,分别行GTSEP和PVP。评估两组患者术前一般情况,记录并比较术后第1个月和第6个月国际前列腺症状评分(IPSS)、生活质量评分(QoLs)、残余尿(PVR)、最大尿流率(Qmax)、前列腺体积(PV)、前列腺特异抗原(PSA)及并发症等。结果两组各有74例患者完成了随访。两组患者术前基本资料差异无统计学意义。术后1、6个月,两组患者下尿路症状均较术前明显改善,但IPSS、QoLs、PVR、Qmax、PSA差异无统计学意义。GTSEP组手术时间明显短于PVP组(41.0±16.4 vs 50.1±18.1 min,P=0.001),术后6个月GTSEP组前列腺体积小于PVP组(22.4±2.4 vs 23.3±1.9 mL,P=0.011)。两组术中和术后近期并发症差异无统计学意义。结论GTSEP与PVP治疗BPH均能获得较好的效果,GTSEP能更大程度去除增生的腺体组织,手术效率优于PVP。展开更多
文摘Objectives:To compare the depth of thermal necrosis after use of bipolar resection and vaporization technique comparing intra-individually bipolar loop and bipolar button electrodes.Methods:Transurethral resection and vaporization of the prostate was performed in 55 male patients(260 specimens in total).In a standardized procedure,a bipolar resection loop was used for resection,and a bipolar button electrode was used for vaporization.Both electrodes were applied in each patient,either in the left or in the right lateral lobe.The depth of necrotic zones in the resected or vaporized tissue of each patient was measured in a standardized way by light microscopy.Results:The mean depth with standard deviation of thermal injury caused by the loop electrode was 0.0495±0.0274 mm.The vaporization electrode caused a mean thermal depth with standard deviation of 0.0477±0.0276 mm.The mean difference of necrosis zone depths between the two types of electrodes(PlasmaButtoneresection loop)was 0.0018 mm(p=0.691).Conclusion:For the first time,we present directly measured values of the absolute necrosis zone depth after application of plasma in the transurethral treatment of benign prostatic hyperplasia.The measured values were lower than in all other transurethral procedures.Standardized procedures of measurement and evaluation allow a statistically significant statement that the low necrosis depth in bipolar procedures is independent of the applied electrodes.
文摘In the past 2 decades,endoscopic enucleation of the prostate has become a safe and effective surgical treatment for benign prostatic hyperplasia(BPH),with comparable outcomes to traditional surgeries.Transurethral vapor enucleation and resection of the prostate(TVERP),transurethral vapor enucleation of the prostate(TVEP),and ultrasound-navigated TVEP(US-TVEP)are new,innovative endoscopic enucleation procedures.These procedures are named Xie’s Prostate Enucleations(Xie’s Procedures for short).Current clinical data indicate that Xie’s Procedures are safe and effective treatment options for patients with BPH,especially for patients with larger prostates.Further prospective,randomized clinical trials compared with traditional transurethral resection of prostate(TURP)are still needed.
文摘目的:对比经尿道等离子体前列腺汽化剜除术(transurethral plasmakinetic vaporization enucleation of the prostate,TPVEP)与经尿道前列腺电切术(transurethral resection of the prostate,TURP)对良性前列腺增生患者性功能的影响。方法:将2012年12月至2014年12月于我院接受手术治疗的92例患者按自愿原则分为TPVEP组与TURP组,术前1d及出院时检查患者生活质量指数QOL、前列腺症状评分IPSS、最大尿流量Qmax及残余尿量RUV,记录手术时间、术中出血量及术中并发症发生率,随访期调查阴茎勃起功能障碍ED与逆行射精(RE)的发生率。结果:(1)两组的手术时间不存在显著差异(P>0.05),而TPVEP组切除腺体的重量大于TURP组,术中出血量、术后置管时间、住院时间均要明显低于TURP组(P<0.01),且其术中、术后并发症发生率也显著低于TURP组(P<0.05);(2)与术前相比,两组患者术后的QOL、IPSS、RUV均显著下降,Qmax显著升高,差异均有统计学意义(P<0.05)。除IPSS评分TPVEP组显著低于TURP组外,其余指标组间对比均无统计学差异(P>0.05);(3)术后6个月,TPVEP组的ED发生率及RE发生率均显著低于TURP组(P<0.05)。术后9个月,两组的发生率均有一定程度的下降,但TPVEP组仍旧显著低于TURP组(P<0.05)。结论:TPVEP术综合了剜除术与等离子汽化系统的优点,具有切除彻底、创伤小、恢复快、疗效确切、并发症少等优点,可显著改善患者尿动力学指标,促进前列腺功能与性功能的恢复。
文摘目的对比经尿道直出光纤绿激光前列腺锐性剜除术(green light top-firing,sharp enucleation of the prostate,GTSEP)和绿激光选择性光汽化术(photoselective vaporisation of the prostate,PVP)治疗良性前列腺增生症(benign prostatic hyperplasia,BPH)患者的有效性和安全性。方法选取2018年6月至2019年4月在本院诊治的154例BPH患者,按随机数字表法分为两组,每组77例,分别行GTSEP和PVP。评估两组患者术前一般情况,记录并比较术后第1个月和第6个月国际前列腺症状评分(IPSS)、生活质量评分(QoLs)、残余尿(PVR)、最大尿流率(Qmax)、前列腺体积(PV)、前列腺特异抗原(PSA)及并发症等。结果两组各有74例患者完成了随访。两组患者术前基本资料差异无统计学意义。术后1、6个月,两组患者下尿路症状均较术前明显改善,但IPSS、QoLs、PVR、Qmax、PSA差异无统计学意义。GTSEP组手术时间明显短于PVP组(41.0±16.4 vs 50.1±18.1 min,P=0.001),术后6个月GTSEP组前列腺体积小于PVP组(22.4±2.4 vs 23.3±1.9 mL,P=0.011)。两组术中和术后近期并发症差异无统计学意义。结论GTSEP与PVP治疗BPH均能获得较好的效果,GTSEP能更大程度去除增生的腺体组织,手术效率优于PVP。
