Background The safety and efficiency of transurethral laser resection of the prostate to treat benign prostatic hyperplasia have been verified. However, this method does still not manage large volume prostates efficie...Background The safety and efficiency of transurethral laser resection of the prostate to treat benign prostatic hyperplasia have been verified. However, this method does still not manage large volume prostates efficiently. To tackle this problem, we have designed a method of ＂transurethral dividing vaporesection of prostate＂ using a 2 micron continuous wave laser. The aim of this study was to evaluate the safety and efficiency of this method in the management of large prostates （〉80 ml）.Methods In this study, 45 cases of benign prostatic hyperplasia with a median prostatic volume of （123.7±26.7） ml （range, 80.2-159.8 ml） were treated by the same surgeon under epidural anesthesia. During the surgery, superapubic catheters were needed, and saline solution was used for irrigation. First, the prostate was divided longitudinally into several parts from the bladder neck to the prostatic apex, and then gradually incised transversely chip by chip. Intraoperative blood transfusion rate, postoperative complications, maximum urinary flow rate, International Prostate Symptom Score and quality of life scores were recorded for statistical analysis using SPSS 16.0 software.Results Intraoperatively, no transurethral resection syndrome was observed, and no blood transfusions were needed.The resected prostatic chips were easily flushed out of the bladder through the resectoscope sheath without the use of a morcellator. Median vaporesection time was （95.0±13.2） minutes （range, 75-120 minutes）, and the median retrieved and removed prostatic tissue were （25.2±5.1） g （range, 15.5-34.7 g） and （75.4±16.4） g （range, 43.8-106.1 g）, respectively. Median catheter time and hospital stay were （3.3±0.9） days （range, 3-5 days） and （4.8±1.8） days （range, 3-9 days）, respectively. After a follow-up of 6 to 12 months, two patients had stress urinary incontinence and three had anterior urethral strictures. Satisfactory improvement was seen in maximum urinary flow rate, International Prostate Symptom Score and quality of life scores.Conclusions This study showed that 2 micron laser vaporesection is a safe treatment for benign prostatic hyperplasia patients with large prostates, and the method of ＂dividing vaporesection＂ may help improve both surgical efficiency and patient outcomes.展开更多
目的:探讨宫腔镜2μm激光治疗围绝经期功能失调性子宫出血(简称功血)的临床疗效。方法:以26例宫腔镜2μm激光子宫内膜去除术治疗的围绝经期功血患者为观察组,26例经宫腔镜子宫内膜电切术治疗的患者为对照组,对两组的手术时间、术中出血...目的:探讨宫腔镜2μm激光治疗围绝经期功能失调性子宫出血(简称功血)的临床疗效。方法:以26例宫腔镜2μm激光子宫内膜去除术治疗的围绝经期功血患者为观察组,26例经宫腔镜子宫内膜电切术治疗的患者为对照组,对两组的手术时间、术中出血量及临床疗效进行比较。结果:观察组的手术时间明显长于对照组(16.9±4.5 min vs 13.9±3.8 min),术中出血量少于对照组(10.6±3.5 mL vs 14.2±4.2 mL),两组比较差异均有统计学意义(P<0.05);观察组总有效率为92.3%,对照组总有效率为96.2%,差异无统计学意义(P>0.05)。结论:宫腔镜2μm激光治疗围绝经期功血疗效确切,并发症少,是一种安全、简便、有效的方法,但对其长远疗效尚须进一步观察。展开更多
文摘Background The safety and efficiency of transurethral laser resection of the prostate to treat benign prostatic hyperplasia have been verified. However, this method does still not manage large volume prostates efficiently. To tackle this problem, we have designed a method of ＂transurethral dividing vaporesection of prostate＂ using a 2 micron continuous wave laser. The aim of this study was to evaluate the safety and efficiency of this method in the management of large prostates （〉80 ml）.Methods In this study, 45 cases of benign prostatic hyperplasia with a median prostatic volume of （123.7±26.7） ml （range, 80.2-159.8 ml） were treated by the same surgeon under epidural anesthesia. During the surgery, superapubic catheters were needed, and saline solution was used for irrigation. First, the prostate was divided longitudinally into several parts from the bladder neck to the prostatic apex, and then gradually incised transversely chip by chip. Intraoperative blood transfusion rate, postoperative complications, maximum urinary flow rate, International Prostate Symptom Score and quality of life scores were recorded for statistical analysis using SPSS 16.0 software.Results Intraoperatively, no transurethral resection syndrome was observed, and no blood transfusions were needed.The resected prostatic chips were easily flushed out of the bladder through the resectoscope sheath without the use of a morcellator. Median vaporesection time was （95.0±13.2） minutes （range, 75-120 minutes）, and the median retrieved and removed prostatic tissue were （25.2±5.1） g （range, 15.5-34.7 g） and （75.4±16.4） g （range, 43.8-106.1 g）, respectively. Median catheter time and hospital stay were （3.3±0.9） days （range, 3-5 days） and （4.8±1.8） days （range, 3-9 days）, respectively. After a follow-up of 6 to 12 months, two patients had stress urinary incontinence and three had anterior urethral strictures. Satisfactory improvement was seen in maximum urinary flow rate, International Prostate Symptom Score and quality of life scores.Conclusions This study showed that 2 micron laser vaporesection is a safe treatment for benign prostatic hyperplasia patients with large prostates, and the method of ＂dividing vaporesection＂ may help improve both surgical efficiency and patient outcomes.
文摘目的:探讨宫腔镜2μm激光治疗围绝经期功能失调性子宫出血(简称功血)的临床疗效。方法:以26例宫腔镜2μm激光子宫内膜去除术治疗的围绝经期功血患者为观察组,26例经宫腔镜子宫内膜电切术治疗的患者为对照组,对两组的手术时间、术中出血量及临床疗效进行比较。结果:观察组的手术时间明显长于对照组(16.9±4.5 min vs 13.9±3.8 min),术中出血量少于对照组(10.6±3.5 mL vs 14.2±4.2 mL),两组比较差异均有统计学意义(P<0.05);观察组总有效率为92.3%,对照组总有效率为96.2%,差异无统计学意义(P>0.05)。结论:宫腔镜2μm激光治疗围绝经期功血疗效确切,并发症少,是一种安全、简便、有效的方法,但对其长远疗效尚须进一步观察。
