Objective To investigate the feasibility and efficacy of transurethral prostate enucleation with 2 μm laser in treatment of benign prostatic hyperplasia ( BPH) . Methods One hundred and seven patients with BPH were t...Objective To investigate the feasibility and efficacy of transurethral prostate enucleation with 2 μm laser in treatment of benign prostatic hyperplasia ( BPH) . Methods One hundred and seven patients with BPH were treated by transurethral prostate enucleation with 2 μm la-展开更多
Recent innovations in thulium laser techniques have allowed application in the treatment of bladder cancer.Laser en bloc resection of bladder cancer is a transurethral procedure that may offer an alternative to the co...Recent innovations in thulium laser techniques have allowed application in the treatment of bladder cancer.Laser en bloc resection of bladder cancer is a transurethral procedure that may offer an alternative to the conventional transurethral resection procedure.We conducted a review of basic thulium laser physics and laser en bloc resection procedures and summarized the current clinical literature with a focus on complications and outcomes.Literature evidence suggests that thulium laser techniques including smooth incision,tissue vaporization,and en bloc resection represent feasible,safe,and effective procedures in the treatment of bladder cancer.Moreover,these techniques allow improved specimen orientation and accurate determination of invasion depth,facilitating correct diagnosis,restaging,and reevaluation of the need for a second resection.Nonetheless,large-scale multicentre studies with longer follow-up are warranted for a robust assessment.The present review is meant as a quick reference for urologists.展开更多
目的:比较经尿道2μm激光前列腺剜除术及前列腺电切术治疗大体积良性前列腺增生的疗效及安全性。方法收集2011~2013年间79例在我院手术治疗的前列腺体积>80 m L患者的临床资料,其中经尿道2μm激光前列腺剜除术45例,前列腺电切术34...目的:比较经尿道2μm激光前列腺剜除术及前列腺电切术治疗大体积良性前列腺增生的疗效及安全性。方法收集2011~2013年间79例在我院手术治疗的前列腺体积>80 m L患者的临床资料,其中经尿道2μm激光前列腺剜除术45例,前列腺电切术34例,比较两组病例的手术时间、切除的腺体组织重量、术中出血量、持续膀胱冲洗时间、留置尿管时间、手术并发症及手术前后最大尿流率(Qmax)、残余尿量(PVRU)、国际前列腺症状评分(IPSS)、以及生活质量评分(QOL)情况。结果79例患者均一次手术成功,两组患者手术时间、术中出血量、持续膀胱冲洗时间、留置尿管时间比较,差异具有统计学意义(P<0.05);两组术中所切除的前列腺体组织重量无统计学差异(P>0.05);两组术后发生暂时性尿失禁、泌尿系感染、二次出血的例数比较,差异具有统计学意义(P<0.05),两组均无死亡病例;两组患者Qmax、PVRU、IPSS及QOL评分较术前均有明显改善(P<0.05),但两组间比较差异均无统计学意义(P>0.05)。结论对于前列腺体积>80 mL的大体积BPH患者,在做好围手术期准备、术者经验丰富的情况下,经尿道2μm激光前列腺剜除术和T U RP均有明显的临床效果,特别是经尿道2μm激光前列腺剜除术更具有术中出血少、安全性高、并发症少等优点。展开更多
The 2-1μm thulium laser resection of the prostate-tangerine technique (TmLRP-TT) has been introduced as a minimally invasive treatment for benign prostatic hyperplasia (BPH). This study was undertaken to assess t...The 2-1μm thulium laser resection of the prostate-tangerine technique (TmLRP-TT) has been introduced as a minimally invasive treatment for benign prostatic hyperplasia (BPH). This study was undertaken to assess the clinical efficacy and safety of TmLRP-TT for the treatment of BPH patients with previously negative transrectal prostate biopsy. A prospective analysis of 51 patients with previously negative transrectal prostate biopsy who underwent surgical treatment using TmLRP-TT was performed from December 2011 to December 2013. Preoperative status, surgical details, and perioperative complications were recorded. The follow-up outcome was evaluated with subjective and objective tests at I and 6 months. TmLRP-TT was successfully completed in all patients. Mean prostate volume, operative duration, and catheterization time were 93.3 ± 37.9 ml, 69.5 ± 39.5 min, and 6.5 ± 1.3 days, respectively. The mean International Prostate Symptom Score, quality of life score, maximum urinary flow rate, and post-void residual urine volume changed notably at 6-month follow-up (22.5 ± 6.9 vs 6.1 ± 3.2, 4.8 ± 1.3 vs 1.1 ± 0.9, 7.3 ± 4.5 vs 18.9 ± 7.1 ml s^-1, and 148.7 ± 168.7 vs 28.4 ± 17.9 ml). Two (3.9%) patients required blood transfusion perioperatively, while 3 (5.9%) patients experienced transient hematuria postoperatively, and 2 (3.9%) patients received 3 days recatheterization due to clot retention. TmLRP-TT is a safe and effective minimally invasive technique for patients with previously negative transrectal prostate biopsy during the 6-month follow-up. This promising technology may be a feasible surgical method for previously negative transrectal prostate biopsy in the future.展开更多
<strong>Introduction:</strong> Lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) is one among the foremost common diseases affecting the aging man with, almost 80% of the ...<strong>Introduction:</strong> Lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) is one among the foremost common diseases affecting the aging man with, almost 80% of the lads greater than 70 affected. BPH is caused by unregulated proliferation within the prostate, which may cause physical obstruction of the prostatic urethra and result in anatomic bladder outlet obstruction (BOO). Transurethral resection of the prostate (TURP) has been the historical gold standard up till now to which all endoscopic procedures for benign prostatic hyperplasia (BPH) are compared with a mean hospital stay of three days. This surgery although efficacious has been related with increased morbidity and increased day case failure rates as compared to newer techniques. These shortcomings have prompted the utilization of newer methods like Transurethral enucleation and resection of the prostate (TUERP), Holmium laser enucleation of the prostate (HoLEP) and Thulium laser enucleation of the prostate (ThuLEP). This review will discuss the enucleation techniques, advantages and therefore the predictive factors for a successful day case prostate surgery. <strong>Materials and Methods:</strong> During this review, we discuss the newer techniques utilized in day case BPH surgery as well as the predictive factors for a successful BPH surgery, both enucleation, benefits and morcellation are covered also. <strong>Results:</strong> TUERP, ThuLEP and HoLEP have literature supporting the advantages of these techniques, which demonstrates its ability in day case BPH surgeries in specially selected cases with favorable factors and a 61% overall success rate. <strong>Conclusion:</strong> TUERP, ThuLEP and HoLEP Have proven to show favorable outcomes in day case BPH surgery with urologist’s experience, prostate size, duration of operation, age, use of anticoagulants, morning theatre list and ASA score being the key factors for a successful day case surgery.展开更多
目的比较经尿道铥激光腔内剜除术和等离子腔内剜除术治疗前列腺增生的效果。方法选取2019年1~12月清远市人民医院泌尿外科收治的64例前列腺增生患者进行研究,采用随机数表法分为观察组和对照组各32例。对照组患者实施经尿道等离子腔内...目的比较经尿道铥激光腔内剜除术和等离子腔内剜除术治疗前列腺增生的效果。方法选取2019年1~12月清远市人民医院泌尿外科收治的64例前列腺增生患者进行研究,采用随机数表法分为观察组和对照组各32例。对照组患者实施经尿道等离子腔内剜除术,观察组患者实施经尿道铥激光腔内剜除术。记录两组患者各项手术指标变化,比较两组患者术后2个月的治疗效果,以及术前和术后2个月的尿道功能、前列腺症状及生活质量评分。结果术后2个月,观察组患者的治疗总有效率为96.88%,明显高于对照组的78.13%,差异有统计学意义(P<0.05);观察组和对照组患者的术中出血量[(104.61±11.27) mL vs (140.52±11.28) mL]、手术时间[(51.77±3.02) min vs(64.39±3.04) min]、冲洗膀胱时间[(18.44±4.25) h vs (30.01±4.26) h]及留置导管时间[(3.95±1.02) d vs (4.78±1.03) d]比较,观察组明显少于或短于对照组,差异均有统计学意义(P<0.05);术前,两组患者的尿道功能、前列腺症状及生活质量比较差异均无统计学意义(P>0.05);术后2个月,观察组患者的最大尿流率为(23.74±1.72) mL/s,明显高于对照组的(21.16±1.73) mL/s、残余尿量为(9.23±1.08) mL,明显少于对照组的(12.45±1.09) mL,差异均有统计学意义(P<0.05);观察组患者的前列腺症状评分为(7.81±2.25)分,明显低于对照组的(15.74±2.26)分,生活质量评分为(82.44±4.28)分,明显高于对照组的(73.75±4.29)分,差异均有统计学意义(P<0.05)。结论与经尿道等离子腔内剜除术比较,经尿道前列腺铥激光腔内剜除术治疗前列腺增生更能有效降低患者的术中出血量,缓解临床症状,改善尿道功能及生活质量,值得临床推广。展开更多
文摘Objective To investigate the feasibility and efficacy of transurethral prostate enucleation with 2 μm laser in treatment of benign prostatic hyperplasia ( BPH) . Methods One hundred and seven patients with BPH were treated by transurethral prostate enucleation with 2 μm la-
文摘Recent innovations in thulium laser techniques have allowed application in the treatment of bladder cancer.Laser en bloc resection of bladder cancer is a transurethral procedure that may offer an alternative to the conventional transurethral resection procedure.We conducted a review of basic thulium laser physics and laser en bloc resection procedures and summarized the current clinical literature with a focus on complications and outcomes.Literature evidence suggests that thulium laser techniques including smooth incision,tissue vaporization,and en bloc resection represent feasible,safe,and effective procedures in the treatment of bladder cancer.Moreover,these techniques allow improved specimen orientation and accurate determination of invasion depth,facilitating correct diagnosis,restaging,and reevaluation of the need for a second resection.Nonetheless,large-scale multicentre studies with longer follow-up are warranted for a robust assessment.The present review is meant as a quick reference for urologists.
文摘目的:比较经尿道2μm激光前列腺剜除术及前列腺电切术治疗大体积良性前列腺增生的疗效及安全性。方法收集2011~2013年间79例在我院手术治疗的前列腺体积>80 m L患者的临床资料,其中经尿道2μm激光前列腺剜除术45例,前列腺电切术34例,比较两组病例的手术时间、切除的腺体组织重量、术中出血量、持续膀胱冲洗时间、留置尿管时间、手术并发症及手术前后最大尿流率(Qmax)、残余尿量(PVRU)、国际前列腺症状评分(IPSS)、以及生活质量评分(QOL)情况。结果79例患者均一次手术成功,两组患者手术时间、术中出血量、持续膀胱冲洗时间、留置尿管时间比较,差异具有统计学意义(P<0.05);两组术中所切除的前列腺体组织重量无统计学差异(P>0.05);两组术后发生暂时性尿失禁、泌尿系感染、二次出血的例数比较,差异具有统计学意义(P<0.05),两组均无死亡病例;两组患者Qmax、PVRU、IPSS及QOL评分较术前均有明显改善(P<0.05),但两组间比较差异均无统计学意义(P>0.05)。结论对于前列腺体积>80 mL的大体积BPH患者,在做好围手术期准备、术者经验丰富的情况下,经尿道2μm激光前列腺剜除术和T U RP均有明显的临床效果,特别是经尿道2μm激光前列腺剜除术更具有术中出血少、安全性高、并发症少等优点。
文摘The 2-1μm thulium laser resection of the prostate-tangerine technique (TmLRP-TT) has been introduced as a minimally invasive treatment for benign prostatic hyperplasia (BPH). This study was undertaken to assess the clinical efficacy and safety of TmLRP-TT for the treatment of BPH patients with previously negative transrectal prostate biopsy. A prospective analysis of 51 patients with previously negative transrectal prostate biopsy who underwent surgical treatment using TmLRP-TT was performed from December 2011 to December 2013. Preoperative status, surgical details, and perioperative complications were recorded. The follow-up outcome was evaluated with subjective and objective tests at I and 6 months. TmLRP-TT was successfully completed in all patients. Mean prostate volume, operative duration, and catheterization time were 93.3 ± 37.9 ml, 69.5 ± 39.5 min, and 6.5 ± 1.3 days, respectively. The mean International Prostate Symptom Score, quality of life score, maximum urinary flow rate, and post-void residual urine volume changed notably at 6-month follow-up (22.5 ± 6.9 vs 6.1 ± 3.2, 4.8 ± 1.3 vs 1.1 ± 0.9, 7.3 ± 4.5 vs 18.9 ± 7.1 ml s^-1, and 148.7 ± 168.7 vs 28.4 ± 17.9 ml). Two (3.9%) patients required blood transfusion perioperatively, while 3 (5.9%) patients experienced transient hematuria postoperatively, and 2 (3.9%) patients received 3 days recatheterization due to clot retention. TmLRP-TT is a safe and effective minimally invasive technique for patients with previously negative transrectal prostate biopsy during the 6-month follow-up. This promising technology may be a feasible surgical method for previously negative transrectal prostate biopsy in the future.
文摘<strong>Introduction:</strong> Lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) is one among the foremost common diseases affecting the aging man with, almost 80% of the lads greater than 70 affected. BPH is caused by unregulated proliferation within the prostate, which may cause physical obstruction of the prostatic urethra and result in anatomic bladder outlet obstruction (BOO). Transurethral resection of the prostate (TURP) has been the historical gold standard up till now to which all endoscopic procedures for benign prostatic hyperplasia (BPH) are compared with a mean hospital stay of three days. This surgery although efficacious has been related with increased morbidity and increased day case failure rates as compared to newer techniques. These shortcomings have prompted the utilization of newer methods like Transurethral enucleation and resection of the prostate (TUERP), Holmium laser enucleation of the prostate (HoLEP) and Thulium laser enucleation of the prostate (ThuLEP). This review will discuss the enucleation techniques, advantages and therefore the predictive factors for a successful day case prostate surgery. <strong>Materials and Methods:</strong> During this review, we discuss the newer techniques utilized in day case BPH surgery as well as the predictive factors for a successful BPH surgery, both enucleation, benefits and morcellation are covered also. <strong>Results:</strong> TUERP, ThuLEP and HoLEP have literature supporting the advantages of these techniques, which demonstrates its ability in day case BPH surgeries in specially selected cases with favorable factors and a 61% overall success rate. <strong>Conclusion:</strong> TUERP, ThuLEP and HoLEP Have proven to show favorable outcomes in day case BPH surgery with urologist’s experience, prostate size, duration of operation, age, use of anticoagulants, morning theatre list and ASA score being the key factors for a successful day case surgery.
文摘目的比较经尿道铥激光腔内剜除术和等离子腔内剜除术治疗前列腺增生的效果。方法选取2019年1~12月清远市人民医院泌尿外科收治的64例前列腺增生患者进行研究,采用随机数表法分为观察组和对照组各32例。对照组患者实施经尿道等离子腔内剜除术,观察组患者实施经尿道铥激光腔内剜除术。记录两组患者各项手术指标变化,比较两组患者术后2个月的治疗效果,以及术前和术后2个月的尿道功能、前列腺症状及生活质量评分。结果术后2个月,观察组患者的治疗总有效率为96.88%,明显高于对照组的78.13%,差异有统计学意义(P<0.05);观察组和对照组患者的术中出血量[(104.61±11.27) mL vs (140.52±11.28) mL]、手术时间[(51.77±3.02) min vs(64.39±3.04) min]、冲洗膀胱时间[(18.44±4.25) h vs (30.01±4.26) h]及留置导管时间[(3.95±1.02) d vs (4.78±1.03) d]比较,观察组明显少于或短于对照组,差异均有统计学意义(P<0.05);术前,两组患者的尿道功能、前列腺症状及生活质量比较差异均无统计学意义(P>0.05);术后2个月,观察组患者的最大尿流率为(23.74±1.72) mL/s,明显高于对照组的(21.16±1.73) mL/s、残余尿量为(9.23±1.08) mL,明显少于对照组的(12.45±1.09) mL,差异均有统计学意义(P<0.05);观察组患者的前列腺症状评分为(7.81±2.25)分,明显低于对照组的(15.74±2.26)分,生活质量评分为(82.44±4.28)分,明显高于对照组的(73.75±4.29)分,差异均有统计学意义(P<0.05)。结论与经尿道等离子腔内剜除术比较,经尿道前列腺铥激光腔内剜除术治疗前列腺增生更能有效降低患者的术中出血量,缓解临床症状,改善尿道功能及生活质量,值得临床推广。