Evaluation of greenlight photoselective vaporization of the prostate for the treatment of high-risk patients with benign prostatic hyperplasia

Aim： To explore the feasibility and safety of greenlight photoselective vaporization of the prostate （PVP） on high-risk patients presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplasia （BPH） and to evaluate their clinical and voiding outcome. Methods： A total of 85 high-risk patients with obstructive BPH underwent PVP with an 80 W potassium-titanyl-phosphate laser, which was delivered through a side-deflecting fiber with a 23 Fr continuous flow cystoscope. Operative time, blood loss, indwelling catheterzation, international prostate symptom score （IPSS）, quality of life score （QoL）, uroflowmetry, postvoid residual urine volume and short-term complication rates were evaluated for all patients. Results： All patients got through the perioperative period safely. The chief advantages of PVP were： short operative time （25.6 ± 7.6 min）, little bleeding loss （56.8 ± 14.3 mL） and short indwelling catheterization （1.6 ± 0.8 d）. The IPSS and QoL decreased from （29.6 ± 5.4） and （5.4 ± 0.6） to （9.5 ± 2.6） and （1.3 ± 0.6）, respectively. The vast majority of patients were satisfied with voiding outcome. The mean maximal urinary flow rate increased to 17.8 mL/s and postvoid residual urine volume decreased to 55.6 mL. These results are significantly different from preoperative data （P 〈 0.05）. No patient required blood transfusion or fluid absorption. There were few complications and very high patient satisfaction after operation. Conclusion： PVP has a short operative time and high tolerance, and is safe, effective and minimally invasive for high-risk patients, therefore it might be considered as a good alternative treatment for high-risk patients with obstructive urinary symptoms as a result of BPH.

Evaluation of greenlight photoselective vaporization of the prostate for the treatment of high-risk patients with benign prostatic hyperplasia

Aim:To explore the feasibility and safely of greenlight photoselective vaporization of the prostate(PVP)on high-risk patients presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplasia(BPH)and to evalu- ate their clinical and voiding outcome.Methods:A total of 85 high-risk patients with obstructive BPH underwent PVP with an 80W potassium-titanyl-phosphate laser,which was delivered through a side-deflecting fiber with a 23 Fr continuous flow cystoscope.Operative time,blood loss,indwelling catheterzation,international prostate symptom score(IPSS),quality of life score(QoL),uroflowmetry,postvoid residual urine volume and short-term complication rates were evaluated for all patients.Results:All patients got through the perioperative period safely.The chief advantages of PVP were:short operative time(25.6±7.6min),little bleeding loss(56.8±14.3mL)and short indwelling catheterization(1.6±0.8d).The IPSS and QoL decreased from(29.6±5.4)and(5.4±0.6)to(9.5±2.6)and(1.3± 0.6),respectively.The vast majority of patients were satisfied with voiding outcome.The mean maximal urinary flow rate increased to 17.8 roLls and postvoid residual urine volume decreased to 55.6mL.These results are signifi- cantly different from preoperative data(P<0.05).No patient required blood transfusion or fluid absorption.There were few complications and very high patient satisfaction after operation.Conclusion:PVP has a short operative time and high tolerance,and is safe,effective and minimally invasive for high-risk patients,therefore it might be considered as a good alternative treatment for high-risk patients with obstructive urinary symptoms as a result of BPH.

A Review of Risk Factors for Predicting Urinary Incontinence after Benign Prostatic Hyperplasia

Benign prostatic hyperplasia (BPH) is one of the common diseases in middle-aged and elderly men, and its clinical symptoms include storage symptoms, voiding symptoms and post-urination symptoms. Surgery is an important treatment method for benign prostatic hyperplasia. It is suitable for BPH patients with moderate to severe LUTS (Lower Urinary Tract Symptoms) and has significantly affected the quality of life. The surgical methods include transurethral resection of the prostate and transurethral holmium laser enucleation of the prostate. While offering a high chance of cure, it also brings some complications, including postoperative urinary incontinence. This article mainly reviews the urinary incontinence after transurethral prostate surgery in recent years and analyzes its risk factors, and summarizes the experience for further prediction and reduction of the incidence of urinary incontinence.

Sonablate-500^(TM) Transrectal High-intensity Focused Ultrasound (HIFU) for Benign Prostatic Hyperplasia Patients

To evaluate the safety and efficacy of transrectal high-intensity focused ultrasound （HIFU） in the treatment of benign prostatic hyperplasia （BPH）, serial studies were conducted in 150 BPH patients before and 30 min, 1, 2, 6 and 12 month（s） after Sonablate-500TM HIFU treatment. A silicon-coated indwelling 16F latex catheter was placed during the determination of the therapy zone. Preoperative and postoperative evaluations were made by using the international prostate symptom score （IPSS）, quality of life （QOL）, uroflowmetric findings and transrectal ultrasound, and incidence of complications. The cystourethrography was done in 23 patients within 1 year postoperatively. The results showed that after HIFU treatment, IPSS and QOL scores were significantly decreased at 1, 2, 6 and 12 month（s） （P〈0.01）. Maximum urine flow rate （6.0 to 17.2 mL/s, P〈0.01）, PVR （75.0 to 30.3, P〈0.01） and prostatic volume （65.0 to 38.1 mL, P〈0.05） were significantly improved 12 months after the operation. Recurrent urinary retention （17=2） and urethrorectal fistula （n=1） occurred at the 15th postoperative day. The duration of the HIFU prostate ablation was 25-90 min. The mean time for an indwelling catheter was 3-19 days. These data demonstrate that treatment of BPH with Sonab- late-500TM HIFU is safe and effective.

Periodontal disease and risk of benign prostate hyperplasia: a cross-sectional study

Background:Both periodontal disease and benign prostatic hyperplasia are age-related diseases that affect millions of people worldwide.Hence,this study aimed to investigate the association between periodontal disease and the risk of benign prostatic hyperplasia.Methods:A total of 4930 participants were selected from an available health examination that was carried out in 2017,only males were considered for further analysis.All eligible males were divided into benign prostatic hyperplasia and normal groups,the benign prostatic hyperplasia group was then divided into prostate volume≤60 g and>60 g subgroups;all their periodontal status was extracted and then into normal(CPI score of 0),periodontal disease(CPI score between 1 and 4),and periodontitis(CPI score between 3 and 4)groups.The correlation between periodontal disease and benign prostatic hyperplasia was investigated using logistic regression analyses and greedy matching case-control analysis.Subgroup analysis based on prostate volume was also performed.All analyses were conducted with SAS 9.4 software.Results:A total of 2171 males were selected for this analysis.The presence of periodontal disease significantly increased the risk of benign prostatic hyperplasia by 1.68 times(OR=1.68,95%CI:1.26–2.24),and individuals with periodontitis showed a higher risk(OR=4.18,95%CI:2.75–6.35).In addition,among matched cases and controls,this association remained robust(periodontal disease:OR=1.85,95%CI:1.30–2.64;periodontitis:OR=4.83,95%CI:2.57–9.07).Subgroup analysis revealed that periodontal disease significantly increased benign prostate hyperplasia risk as well(for prostate volume≤60 g:OR=1.64,95%CI:1.22–2.20;for volume>60 g:OR=2.17,95%CI:1.04–4.53),and there was a higher risk in the group with a prostate volume greater than 60 g.Conclusions:Periodontal disease is significantly and positively associated with an increased risk of benign prostatic hyperplasia.Further validation studies should be performed to explore the relationship between periodontal treatment and benign prostate hyperplasia.

Comparison of the predictive value of anthropometric indicators for the risk of benign prostatic hyperplasia in southern China

This study aimed to compare the predictive value of six selected anthropometric indicators for benign prostatic hyperplasia(BPH).Males over 50 years of age who underwent health examinations at the Health Management Center of the Second Xiangya Hospital,Central South University(Changsha,China)from June to December 2020 were enrolled in this study.The characteristic data were collected,including basic anthropometric indices,lipid parameters,six anthropometric indicators,prostate-specific antigen,and total prostate volume.The odds ratios(ORs)with 95%confidence intervals(95%CIs)for all anthropometric parameters and BPH were calculated using binary logistic regression.To assess the diagnostic capability of each indicator for BPH and identify the appropriate cutoff values,receiver operating characteristic(ROC)curves and the related areas under the curves(AUCs)were utilized.All six indicators had diagnostic value for BPH(all P≤0.001).The visceral adiposity index(VAI;AUC:0.797,95%CI:0.759–0.834)had the highest AUC and therefore the highest diagnostic value.This was followed by the cardiometabolic index(CMI;AUC:0.792,95%CI:0.753–0.831),lipid accumulation product(LAP;AUC:0.766,95%CI:0.723–0.809),waist-to-hip ratio(WHR;AUC:0.660,95%CI:0.609–0.712),waist-to-height ratio(WHtR;AUC:0.639,95%CI:0.587–0.691),and body mass index(BMI;AUC:0.592,95%CI:0.540–0.643).The sensitivity of CMI was the highest(92.1%),and WHtR had the highest specificity of 94.1%.CMI consistently showed the highest OR in the binary logistic regression analysis.BMI,WHtR,WHR,VAI,CMI,and LAP all influence the occurrence of BPH in middle-aged and older men(all P≤0.001),and CMI is the best predictor of BPH.

经尿道前列腺等离子双极电切术治疗高危良性前列腺增生患者的多中心、前瞻性研究

目的探讨经尿道前列腺等离子双极电切术(transurethral plasmakinetic resection of prostate,TUPKP)治疗高危良性前列腺增生(BPH)患者的临床疗效。方法采用前瞻性多中心研究设计。在全国20家医院泌尿外科按照纳入排除标准,入组行TUPKP治疗的高危BPH患者,分析患者基线、围手术期及术后3个月随访的相关数据,评价疗效和安全性。结果2016年9月至2018年12月共入组229名高危BPH患者。与基线相比,术后3个月随访的国际前列腺症状评分改变量为-17.28[95%CI(-18.02,-16.54)]分、最大尿流率改变量为5.61[95%CI(0.68,10.54)]mL·s^(-1)、残余尿量改变量为-84.50[95%CI(-96.49,-72.51)]mL、生活质量评分改变量为-3.24[95%CI(-3.42,-3.06)]分,差异均具有统计学意义(P<0.05)。术中及术后并发症的发生率低,未发生与手术相关的不良事件。结论TUPKP可以用于治疗高危BPH患者,建议由技术熟练的术者实施手术。

Correlation between molecular biomarkers and risk factors for the clinical progression of benign prostatic hyperplasia using tissue microarray immunostaining

Background The pathogenesis of benign prostatic hyperplasia （BPH） has been widely studied,and several biomarkers are known to play roles in its development.This study aimed to investigate the possible role of cysteine-rich protein 61 （CYR61）,vascular endothelial growth factor （VEGF）,androgen receptor （AR）,interleukin-6 （IL-6）,cytochrome c,caspase-3,and proliferating cell nuclear antigen （PCNA） in the clinical progression of BPH.Methods Tissue specimens from 96 BPH cases who underwent transurethral resection of the prostate were processed and transferred to tissue microarrays.Patient age,prostate volume,serum prostate-specific antigen （PSA） level,and International Prostate Symptom Score （IPSS） of all BPH cases were collected before surgery.The expression of CYR61,VEGF,AR,IL-6,cytochrome c,caspase-3,and PCNA was examined by immunostaining in the BPH specimens,and any possible correlation between the different biomarkers and risk factors for BPH clinical progression was analyzed.Results The expression of CYR61,VEGF,AR,IL-6,cytochrome c,caspase-3,and PCNA in the BPH cases was 68.8％ （66/96）,77.1％ （74/96）,43.8％ （42/96）,31.3％ （30/96）,35.4％ （34/96）,56.3％ （54/96）,and 29.2％ （28/96）,respectively.The expression of both CYR61 and VEGF was positively correlated with patient age,prostate volume,and serum PSA level （P ＜0.05）.Furthermore,cytochrome c and caspase-3 expression were inversely related to prostate volume （P ＜0.05）,and AR expression was positively related to serum PSA level （P ＜0.05）.Conclusion CYR61 and VEGF expression might serve as biomarkers for predicting the clinical progression of BPH due to effects on stromal cell proliferation and angiogenesis.

良性前列腺增生术后阴茎勃起功能障碍发生风险的列线图模型建立与风险分层

目的探讨良性前列腺增生(BPH)患者术后阴茎勃起功能障碍(ED)发生的风险因素,并建立列线图模型及风险分层标准,为临床防治ED提供参考。方法回顾性分析2021年1月至2023年6月新乡医学院第一附属医院收治的120例BPH术后患者的临床资料,根据术后是否发生ED分组,其中ED组60例,非ED组60例。比较两组患者的临床资料,采用Logistic回归方程分析BPH患者术后ED发生的影响因素,采用R-3.4.5软件语言建立列线图模型,绘制受试者工作特征曲线(ROC)、校准曲线、曲线下面积(AUC)、决策曲线(DCA)分析列线图模型预测效能,采用递归分割法建立ED发生风险分层系统。结果ED组患者中合并高血压、抑郁症、糖尿病、下尿路症状≥2项的例数占比分别为46.67%、31.67%、43.33%、45.00%,明显高于非ED组的28.33%、15.00%、23.33%、25.00%,差异均有统计学意义(P<0.05);ED组患者的一氧化氮(NO)、睾酮(T)水平分别为(40.42±5.56)nmol/mL、(2.11±0.60)μg/L,明显低于非ED组的(46.78±6.12)nmol/mL、(2.72±0.81)μg/L,而内皮素-1(ET-1)水平为(71.88±8.89)ng/L,明显高于非ED组的(60.02±10.23)ng/L,差异均有统计学意义(P<0.05);ED组患者收缩期峰值流速(PSV)、舒张末期流速(EDV)、阻力指数(RI)分别为(7.56±2.27)cm/s、(20.23±3.58)cm/s、0.59±0.17,明显小于非ED组的(10.22±2.69)cm/s、(25.51±4.36)cm/s、0.78±0.23,差异均有统计学意义(P<0.05);Logistic回归分析结果提示,高血压、抑郁症、糖尿病、NO、ET-1、T均是BPH术后ED发生风险的影响因素(P<0.05);基于上述影响因素构建的BPH术后ED发生风险的列线图预测模型的AUC为0.862,95%CI为0.796~0.927;DCA曲线显示该模型具有正向净获益;危险分层分析结果显示,高风险患者ED发生率为85.71%(36/42),高于中等风险的32.56%(14/43)和低风险的28.57%(10/35),差异有统计学意义(P<0.05)。结论高血压、抑郁症、糖尿病、NO、ET-1、T均是BPH术后ED发生风险的影响因素,基于上述影响因素建立的预测模型预测效能较高,基于预测模型的危险分层系统能较好地识别高危险患者,便于指导临床治疗。

中老年男性体检人群良性前列腺增生关联因素研究

背景寻找良性前列腺增生(benign prostatic hyperplasia,BPH)发生的影响因素有助于对BPH进行早期预防。目的探讨中老年男性体检人群临床指标与前列腺体积的相关性,寻找BPH的关联因素。方法回顾性分析2021年6月—2023年6月某三甲医院体检中心行健康检查的中老年男性的资料,以前列腺总体积(total prostate volume,TPV)为分组标准,TPV>25 cm3为BPH组,TPV≤25 cm3为健康对照组,采用Spearman相关性分析和多因素Logistic回归分析与TPV相关的因素。结果共纳入6732例45~89岁中老年男性,其中BPH组3972例,健康对照组2760例。与健康对照组相比,BPH组年龄[M(IQR):56(51~60)岁vs 53(49~58)岁,P<0.001]、体质量指数(body mass index,BMI)[M(IQR):26.41(24.64~28.36)kg/m^(2) vs 25.76(24.06~27.80)kg/m^(2),P<0.001]、空腹胰岛素(insulin,INS)[M(IQR):10.67(7.27~15.53)mmol/L vs 10.25(6.90~14.93)mmol/L,P=0.005]、总前列腺特异性抗原(total prostate specific antigen,tPSA)[M(IQR):1.01(0.66~1.63)ng/L vs 0.75(0.51~1.10)ng/L,P<0.001]较高,高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)[M(IQR):1.18(1.00~1.37)mmol/L vs 1.19(1.01~1.40)mmol/L,P=0.004]、游离前列腺特异性抗原(free prostate specific antigen,fPSA)/tPSA[M(IQR):0.31(0.23~0.41)vs 0.32(0.24~0.42),P=0.016]较低。相关性分析显示,TPV与年龄(r=0.24,P<0.001)、tPSA(r=0.33,P<0.001)、fPSA(r=0.36,P<0.001)均呈显著正相关。多因素Logistic回归分析结果显示,随着年龄(OR=1.051,95%CI:1.042~1.060,P<0.001)、BMI(OR=1.095,95%CI:1.076~1.116,P<0.001)和tPSA(OR=1.775,95%CI:1.647~1.913,P<0.001)的增长或升高,BPH的发病风险升高,但高HDL-C男性发生BPH的概率较低(OR=0.790,95%CI:0.665~0.945,P=0.009)。结论tPSA、年龄、BMI、HDL-C与前列腺增生发生有关。

450 nm蓝激光汽化术治疗高危前列腺增生患者临床疗效评价

目的:450 nm蓝激光半导体治疗机行经尿道蓝激光汽化术治疗高危前列腺增生(BPH)患者临床疗效评价。方法:纳入青海红十字医院泌尿外科2023年1月至9月BPH患者80例,随机数表法分为研究组和对照组,每组40例。研究组采用经尿道蓝激光汽化术,对照组采用经尿道前列腺电切术(TURP)。对比两组患者手术时间、术后膀胱持续冲洗及导尿管留置时间、术中术后血红蛋白下降值,下床活动时间、前列腺症状改善及并发症发生情况。结果:80例BPH患者均顺利完成手术,TURP组8例患者术中行膀胱造瘘术,研究组术中均未行膀胱造瘘术,研究组较对照组手术耗时短、出血量少、术后膀胱冲洗及导尿管留置时间短、下床活动时间早(P<0.05)。两组患者与术前比较IPSS、PRV均明显下降、Qmax显著升高(P<0.05),术后两组患者组间比较IPSS、PRV、Qmax无显著性差异(P>0.05)。总体并发症发生率低于对照组(P<0.05)结论:经尿道450 nm蓝激光汽化术治疗BPH止血高效、手术耗时短、术中膀胱造瘘率低、并发症少,可有效缩短膀胱冲洗及导尿管留置时间,术后排尿良好,治疗高风险性BPH具有一定的优势性。

勃起功能障碍和下尿路症状在良性前列腺增生患者中的合并发生率及危险因素分析

目的:研究勃起功能障碍(ED)和下尿路症状(LUTS)在良性前列腺增生(BPH)人群中的合并发生率及危险因素分析。方法:2020年1月至2023年1月在中南大学湘雅二医院门诊就诊的BPH患者,根据纳入和排除标准确定纳入本研究的对象,收集一般资料和临床资料(包括年龄、身高、体重、腹围、臀围、血压、血常规、肝功能、肾功能、血脂和空腹血糖等),通过问卷调查进行国际前列腺症状评分(IPSS)、生活质量评分(QOL评分)和国际勃起功能指数(IIEF-5)评分。采用SPSS 22.0软件进行数据处理与分析。结果:ED合并LUTS在BPH患者各年龄组发生率分别为45~49岁组36.46%,50~54岁组43.72%,55~59岁组53.66%,60~64岁组69.23%,65~70岁组78.74%。LAP、VAI、TyG、HSI、BMI、WHtR、WHR、TG/HDL-C与IPSS得分呈正相关,与IIEF-5得分呈负相关;HDL-C/TC与IPSS得分呈负相关,与IIEF-5得分呈正相关。结论:ED合并LUTS在BPH患者中的发生率随年龄增加而增高,高血压、血脂异常、糖尿病、身高体重指数(BMI)、生活方式可能是ED合并LUTS发生的危险因素,LAP、VAI、TyG、HSI、BMI、WHtR、WHR、TG/HDL-C可有效评估ED合并LUTS在BPH患者中发生的风险。

良性前列腺增生患者经尿道前列腺切除术后发生深静脉血栓形成的影响因素分析

目的:探讨良性前列腺增生(BPH)患者经尿道前列腺切除术(TURP)后发生深静脉血栓形成(DVT)的影响因素。方法:回顾性分析2017年1月—2023年5月济南市第一人民医院收治的588例BPH患者的临床资料,根据术后DVT发生与否,将患者分为DVT组和对照组,DVT组104例,对照组484例。对比分析两组患者的性别、年龄、冠心病史等资料,将组间比较有显著差异的变量代入logistic回归进行多因素分析,筛选TURP后发生DVT的影响因素。结果:DVT组脑梗死病史占比、中性粒细胞计数、中性粒细胞-淋巴细胞比值(NLR)、血小板-淋巴细胞比值(PLR)均高于对照组,淋巴细胞计数、血小板-中性粒细胞比值(PNR)均低于对照组,差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,脑梗死史(脑梗死恢复期)、中性粒细胞计数、PNR是BPH患者经尿道前列腺切除术后发生DVT的危险因素(P<0.05)。结论:脑梗死恢复期、较高的中性粒细胞计数和较低的PNR可增加BPH患者经尿道前列腺切除术后发生深静脉血栓形成的风险。

经尿道两种不同手术方式治疗高危良性BPH的效果比较

目的:探讨经尿道两种不同手术方式治疗高危良性前列腺增生(BPH)效果比较。方法:回顾分析2021年6月至2023年6月我院收治108例高危BPH患者临床资料,依据手术方式不同分成电切组(n=42)与剜除组(n=66)。分析两组治疗效果。结果:剜除组手术、导管滞留及住院时间均短于电切组,术中出血量及剩余腺体质量少于电切组(P<0.05);剜除组国际前列腺症状评分、残余尿量、前列腺特异性抗原、前列腺素E2及睾酮水平低于电切组,最大尿流率水平、国际勃起功能问卷评分、早泄患者性功能-5评分法评分均高于电切组(P<0.05)。结论:对高危良性BPH患者采用经尿道前列腺等离子剜除术治疗效果更好。

良性前列腺增生患者行经尿道切除术后发生尿路感染相关危险因素调查与防护措施分析

目的分析良性前列腺增生(BPH)患者行经尿道切除术(TURP)后发生尿路感染相关危险因素与防护措施。方法选择于我院行TURP的80例BPH患者,根据尿路感染发生情况分为两组,分析BPH患者行TURP术后发生尿路感染的危险因素,并制定防护措施。结果80例BPH患者中有15例患者发生术后尿路感染。单因素分析显示,感染组术前进行导尿术、合并糖尿病、术前未使用抗生素、导尿管留置时间>5 d占比均高于未感染组(P<0.05)。Logistic回归分析结果显示,术前进行导尿术、合并糖尿病、术前未使用抗生素、导尿管留置时间>5 d是BPH患者行TURP术后发生尿路感染的独立危险因素(OR>1,P<0.05)。结论BPH患者TURP术后易发生尿路感染,术前进行导尿术、合并糖尿病、术前未使用抗生素、导尿管留置时间>5d是其独立危险因素,及时制定防护措施可减少尿路感染发生。

基于IMB模型的风险预警护理对良性前列腺增生患者康复的影响

目的 探讨基于信息-动机-行为技巧(IMB)模型的风险预警护理对良性前列腺增生患者康复的影响。方法 选取我院2022年08月到2023年08月收治的82例良性前列腺增生患者,应用随机数字表法将其分为观察组与对照组,各组均为41例。所有患者均采取经尿道等离子电切术治疗,对照组采取围术期常规护理,观察组在对照组基础上增加IMB模型的风险预警护理,分别在护理前后应用自我护理能力量表(ESCA)对患者自我护理能力进行评价,对比两组首次下床时间、尿管拔除时间、首次进食时间和住院时间,最后对比两组并发症发生情况。结果 护理后两组的健康知识水平、自我护理技能、自护责任感、自我概念相关ESCA评分均升高,且观察组高于对照组(P<0.05);观察组患者首次下床时间、尿管拔除时间、首次进食时间和住院时间明显低于对照组(P<0.05);观察组术后并发症发生率明显低于对照组(P<0.05)。结论 基于IMB模型的风险预警护理对良性前列腺增生患者围术期护理效果显著,可提升患者自我护理能力,促进其早日康复,辅助降低术后并发症发生率。

良性前列腺增生患者经微创手术治疗后出现尿道狭窄的高危因素调查

目的:探讨良性前列腺增生(BPH)患者经微创手术治疗后尿道狭窄的高危因素。方法:回顾性分析2021年8月—2023年8月首钢水钢医院收治的85例BPH患者的临床资料,所有患者均行经尿道前列腺电切术(TURP)治疗,依据术后是否出现尿道狭窄分为尿道狭窄组(n=19)、非尿道狭窄组(n=66),收集两组年龄、病程、手术时间、术后留置导尿管时间、合并高血压、合并糖尿病、伴尿道感染、前列腺体积、术中出血量、术后膀胱冲洗时间、持续牵引气囊导尿管时间、术中行尿道扩张等多方面基础资料,先行单因素分析,再行logistic回归分析,获得影响BPH患者微创手术后尿道狭窄的高危因素。结果:85例患者共出现19例尿道狭窄,发生率为22.35%(19/85)。尿道狭窄组手术时间≥70 min、术后留置尿管时间≥7 d、合并糖尿病、伴尿道感染、前列腺体积≥70 mL、持续牵引气囊导尿管时间≥15 h、术中行尿道扩张患者占比高于非尿道狭窄组,差异均有统计学意义(P<0.05)。多因素分析显示,手术时间≥70 min、术后留置导尿管时间≥7 d、合并糖尿病、伴尿道感染、前列腺体积≥70 mL、持续牵引气囊导尿管时间≥15 h、术中行尿道扩张为影响BPH患者微创手术后尿道狭窄的高危因素(P<0.05)。结论:BPH患者微创术后尿道狭窄发生与手术时间、术后留置导尿管时间、合并糖尿病、伴尿道感染、前列腺体积、持续牵引气囊导尿管时间、术中行尿道扩张关系密切,还需做好干预措施,降低尿道狭窄风险。

基于希望理论的护理在高危高龄前列腺增生患者围术期的应用效果分析

目的:分析基于希望理论的护理在高危高龄前列腺增生患者围术期的应用效果。方法:选取2021年1月—2022年1月南京医科大学附属南京医院收治的高危高龄前列腺增生患者87例作为研究对象,随机分为对照组(n=44)和研究组(n=43)。对照组实施常规护理,研究组在对照组基础上实施基于希望理论的护理。比较两组希望水平、术后恢复情况。结果:护理后,两组对现实和未来抱有积极态度、采取积极行动、与他人保持亲密关系评分及总分高于护理前,且研究组高于对照组,差异有统计学意义(P<0.05)。研究组术后首次活动时间、术后首次进食时间、术后尿管留置时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。结论:基于希望理论的护理在高危高龄前列腺增生患者中的应用效果显著,可提高患者希望水平,加速恢复进程。

经尿道前列腺等离子剜除术治疗高龄高危前列腺增生的疗效及安全性观察

分析高龄高危前列腺增生患者的生理特点,研究经尿道前列腺等离子剜除术(TUERP)的优势。选择泰安八十八医院2020年9月—2021年9月收治的高龄高危前列腺增生患者58例作为研究对象,随机将其分为观察组和对照组,每组各29例患者。观察组患者采取经尿道前列腺等离子剜除术治疗,对照组患者采取经尿道等离子前列腺电切术(TURP)治疗。观察两组患者的手术时间、术中出血量、切除腺体组织数量等相关手术指标、术后并发症发生率、治疗前和术后3个月的生活质量(QOL)、性功能(IIEF-5)评分、治疗前后尿流动力学(Urodynamics)和前列腺特异抗原(PSA)指标。结果显示:观察组患者术中各项指标都优于对照组,术后并发症的发生率低于对照组,组间结果差异显著(P<0.05)。研究发现,高龄高危前列腺增生患者采用经尿道前列腺等离子剜除术治疗更具安全性,不仅能缩短患者手术时间,还能降低并发症的发生率。

良性前列腺增生患者术后尿路感染病原菌特征及危险因素分析

目的:分析良性前列腺增生(BPH)患者术后尿路感染的病原菌特征及危险因素。方法:选取2021年5月—2023年6月于阳江市人民医院泌尿外科择期行经尿道前列腺1470nm激光汽化术治疗的100例BPH患者临床资料进行分析,其中术后发生尿路感染者42例(感染组),未感染者58例(非感染组)。收集两组各项基线资料与手术资料,分析尿路感染的病原菌特征及危险因素。结果:感染组患者42例共检出病原菌57株,以革兰阴性菌多见(占61.40%),其次为革兰阳性菌(占35.09%)、真菌(占3.51%)。Logistic回归分析结果显示,吸烟时间≥10年、合并营养不良与糖尿病、术前行尿潴留导尿术及术后留置尿管时间长为术后尿路感染的独立危险因素(P<0.05)。结论:BPH患者术后尿路感染的病原菌主要为革兰阴性菌,危险因素包括吸烟、营养不良、糖尿病、术前尿潴留导尿术、术后留置尿管时间长等。