Progressive pre-disconnection of urethral mucosal flap during transurethral plasmakinetic enucleation of prostate improves postoperative urinary continence / 浙江大学学报·医学版

OBJECTIVES@#To investigate the effect of progressive pre-disconnection of urethral mucosal flap during transurethral plasmakinetic enucleation of prostate (TUPEP) on early recovery of urinary continence.@*METHODS@#Clinical data of patients with benign prostatic hyperplasia (BPH) admitted in Zhujiang Hospital of Southern Medical University during February and May 2022 were collected. All the patients underwent TUPEP, and the progressive pre-disconnection of urethral mucosal flap was performed in the procedure. The total operation time, enucleation time, postoperative bladder irrigation time and catheter indwelling time were recorded. Urinary continence was evaluated 24 h, 1 week, and 1, 3, 6 months after the removal of urinary catheter.@*RESULTS@#All surgeries were successfully completed at one time with less intraoperative bleeding, and there were no complications such as rectal injury, bladder injury or perforation of prostate capsule. The total operation time was (62.2±6.5) min, the enucleation time was (42.8±5.2) min, the postoperative hemoglobin decrease by (9.5±4.5) g/L, the postoperative bladder irrigation time was (7.9±1.4) h, and the postoperative catheter indwelling time was 10.0 (9.2, 11.4) h. Only 2 patients (3.6%) had transient urinary incontinence within 24 h after catheter removal. No urinary incontinence occurred at 1 week, and 1, 3, 6 months after operation, and no safety pad was needed. The Qmax at 1 month after operation was 22.3 (20.6, 24.4) mL/s, international prostate symptom scores were 8.0 (7.0, 9.0), 5.0 (4.0, 6.0) and 4.0 (3.0, 4.0) at 1, 3 and 6 months after surgery, and quality of life scores at 1, 3 and 6 months after surgery were 3.0 (2.0, 3.0), 2.0 (1.0, 2.0) and 1.0 (1.0, 2.0), all of these indicators were better than those before surgery (all P<0.01).@*CONCLUSIONS@#In the treatment of BPH, the application of progressive pre-disconnection of urethral mucosal flap in TUPEP can completely remove the hyperplastic glands and promote early recovery of postoperative urinary continence with less perioperative bleeding and decreased surgical complications.

Comparison of the clinical effects of transurethral plasmakinetic enucleation of prostate and suprapubic transvesical prostatectomy in the treatment of large volume benign prostatic hyperplasia / 中国综合临床

Objective To assess the clinical efficacy and safety of transurethral plasmakinetic enucleation of prostate (PKEP) and suprapubic transvesical prostatectomy (SPP) in the treatment of large volume benign prostatic hyperplasia (BPH).Methods A total of eighty patients with large volume BPH were selected in the First People''s Hospital of Xuzhou from March 2014 to December 2016,and they were randomly divided into two groups,the PKEP group and SPP group,with 40 cases in each group.The comparison was made between the two groups in terms of operation indicators,postoperative complications followed up for 6 months after surgery and other related curative effect indexes.Results In the SPP group,the intraoperative blood loss was significantly higher than that of the PKEP group ((215.7±10.4) ml vs.(75.6±9.2) ml,t=6.541,P0.05).But the catheterization time after operation,bladder irrigation time and length of hospital stay were significantly longer in the PKEP group than in the SPP group ((6.3±1.8) d vs.(2.4±0.6) d,(5.5±1.4) d vs.(1.3±0.6) d,(7.7±2.3) d vs.(3.1±0.7) d,t=4.357,2.542,2.975,P0.05).The rate of complication occurrence in the PKEP group were lower than that of the SPP group (P<0.05).Conclusion PKEP was effective in the treatment of BPH,with less bleeding loss,fewer complications and quick recovery.It can significantly improve the life quality of the patients and will be an ideal treatment for large volume BPH.

Transurethral plasmakinetic enucleation of prostate for treating high-risk huge benign prostate hyperplasia / 重庆医学

Objective To research the clinical effect of transurethral plasmakinetic enucleation of prostate (PKEP) in the treatment of high-risk huge benign prostate hyperplasia(BPH).Methods Fifty-two cases of high-risk huge(＞120 g) BPH in this hospita1 from May 2010 to May 2015 were selected and performed PKEP.International prostate symptoms score(IPSS),quality of life(QOL) score,residual urine(RUV) and biggest urine flow rate(Qmax) were observed after operation.Results The mean operation time was (130.12 ± 12.14) min,the mean intraroperation bleeding amount was (120.24±9.81) mL,the mean hospital stay was (14.52 ± 1.82)d,the mean weight of resected prostate tissues was (113.42 ± 12.53)g.Follow-up lasted for 6 months without serious complications.IPSS、QOL,RUV and Qmax after operation were improved obviously,the difference was statistically significant compared with before operation(P＜0.05).Conclusion PKEP is safe and effective in the treatment of high-risk huge BPH.