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Objective To evaluate the feasibility and safety of 180W greenlight laser in the treatment of benign prostatic hyperplasia (BPH) in the day surgery mode.Methods A retrospective review included 65 patients with benign prostate hyperplasia who were treated with photoselective vaporization of the prostate (PVP) under 180W greenlight system from Jan 2017 to Jan 2018,was performed.The patients' age ranged from 54 to 75 years old and the prostatic volume ranged from 42 to 93 ml.All patients were classified into two groups [day sugery group (n =29) and inpatient surgery group(n =36)] based on the wishes of patients.In day sugery group,the admission,operation and discharge were completed in 24 hours.The preoperative clinic parameters such as prostate volume,IPSS,Qmax QOL and PVR were recorded in the two groups.The prostatic volume in two groups was (67.3 ± 15.9) ml and (70.4 ± 16.1) ml,respectively.The IPSS and QOL scores in two groups were (23.2±4.6 vs.23.9±4.5) and (4.7±0.9 vs.4.4± 0.8),respectively.The Q and PVR in two groups were [(6.7 ± 2.5) ml/s vs.(6.8 ± 2.8) ml/s] and [(133.9 ± 81.3) ml vs.(105.8 ± 76.3) ml],respectively.The time of catheterization and postoperative hospitalization,total cost,postoperative adverse events were recorded,too.All the clinic data of preoperation,intraoperation and postoperation were compared between two groups.Results The operations and follow-up were successfully executed in all patients.There were not statistical significance differences in preoperative parameters between the two groups (P ＞ 0.05).There were not statistical significance differences in operating time [(67.8 ± 9.8) min vs.(70.9 ± 12.8) min],laser time [(49.8 ± 8.3) min vs.(51.6±10.4) min],energy used [(295.7±112.6) kJ vs.(285.0±108.2) kJ],between the two groups,too (P ＞ 0.05).A significantly less mean catheter duration,hospital stay and hospital charges were observed in the day surgery group [(14.6 ±2.0)hours,(0.5 ±0) days and (23 279 ±511) yuan,respectively] than in the inpatient surgery group [(51.7 ± 1 1.8) hours,(3.0 ± 0.8) days and (27 452 ± 440)yuan,respectively,P ＜0.05].3 cases of urinary retention and 1 case of gross hematuria after the catheter removal were recorded in the day surgery group,2 cases of urinary retention were recorded in the inpatient surgery group,and all of these 6 cases were cured through indwelling catheter.After 3 months follow up,there were not statistical significant differences io IPSS(12.4 ± 3.3 vs.10.6 ± 4.2),Q [(17.4±2.1)ml/s vs.(17.1 ±1.8) ml/s],and QOL (2.1 ±0.7 vs.2.3±0.7)between the two groups (P ＞ 0.05).However,significant difference of those items could be noticed when compared with those items before surgery (P ＜ 0.05).Conclusions In the day surgery mode,180W greenlight laser vaporization of the prostate is safe and effective,without the increase of surgical complications.The length of stay and hospitalization expenses were much less.Thus,this strategy is worth promoting in clinical practice.
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Objective To prevent the occurrence of postoperative delirium after endoscopic surgery in patients with benign prostatic hyperplasia (BPH). Methods A total of 370 BPH patients receiving endoscopic surgery in our hospital were involved in this study. The clinical parameters including age, other systemic diseases, operation method, operation time and postoperative pain were investigated as predictive risk factors. Then the data were dealt by χ~2 test, single factor analysis or multivariate logistic regression analysis. Results Postoperative delirium occurred in 19 cases (5. 1%). Univariate analysis demonstrated that many factors were significantly correlated with the postoperative delirium in elderly patients, such as age (χ~2 = 7. 37, P<0. 05), other systemic diseases (χ~2=10.26, P<0.05), operation time (χ~2 = 19. 87, P<0.05) and postoperative pain (χ~2= 4.99, P<0. 05). The multivariate logistic regression analysis showed that age (OR = 5. 38, P< 0.05), other systemic diseases (OR = 4. 97, P<0. 05) and operation time (OR = 6. 53, P<0. 05) were important factors for postoperative delirium. Conclusions Paying more attention to the advanced age, giving sufficient preoperative preparation and reducing operation time may help to prevent postoperative delirium.
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Objective To investigate the value of transrectal Doppler and contrast-enhanced ultrasonography(CETRUS)to discriminate benign and cancerous nodules in prostate. Methods Fifty-five patients with hypoechoic lesions(35 biopsy-proven benign nodules and 32 prostate cancer nodules)in the prostate underwent Color and power Doppler uhrasonography(PDUS),and the parameter of peak vascularization index(PVI)in each prostate nodule was recorded and the differences of PVI in the benign and cancerous nodules were analyzed.CETRUS was then performed on all cases.The enhancement patterns of the lesions and their surrounding peripheral zone tissues were observed.After CETRUS,lesion-specific TRUS-guided biopsy and the routine sextant biopsy were performed subsequently. Results PVI of 32 prostate cancerous nodules and 35 prostate benign nodules were (0.38±0.16),(0.24±0.19),respectively,measured by color Doppler ultrasonography.And the former was significantly higher than the latter(P=0.0023).PVI of the cancerous nodules and the benign nodules were(0.55±0.18),(0.32±0.21)(P<0.01).Malignant lesions showed significant increased peak intensity and earlier arrival time compared with their surrounding outer gland tissue,while benign lesions showed nearly equal peak intensity and time to enhancement compared with their surrounding gland tissue by CETRUS. Conclusions PVI measured by PDUS was more effective than that measured by color Doppler to discriminate benign and cancerous nodules in prostate.CETRUS could be helpful in discriminatory performance of benign and cancerous nodules in prostate.
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Objective To summarize and evaluate the transurethral electrovaporization of prostate (TVP), a minimally invasive method for elderly patients with benign prostatic hyperplasia(BPH). Methods After full preparation,TVP was performed on 96 cases of 70 95 year old BPH patients, and all patients were followed up for 3 6 months after operation. Results On the average,the operation time was 48 minutes, blood loss 88 ml, catheterization time was 4 5 days. The patients had satisfactory voiding after removal of the catheter and the average post operative hospital stay was 6 5 days. By 3 6 months of follow up, I PSS score dropped to 9 8 and 6 5; peak urine flow increased to 13 6 15 8 ml/s, residual urine dropped to 28 5 12 0 ml( P