RESUMO
Objective To establish a prostate urethral re-epithelialization model with Chinese rural canine by 2 μm laser vaporization resection.Methods We used 2 μm laser to vaporiz prostate of 15 uncastrated male Chinese rural canines from March to April in 2016.These canines mean age was (6.3 ± 0.6) years(ranging 5-7 years),and weight was (20.5 ± 1.3) kg(ranging 18-22 kg).We began to surgery in which we saw the protruding part of the prostate in urethra,and narrow prostate urethra after a successful anesthesia by intraperitoneal injection of chloral hydrate.The operation time,anesthesia time,survival rate,first time to drink water,first time to feed,first time to stand,first time to defecate,the time when canine bladders rinse became clear,wound healing time were recorded.After 3 days,1 week,2 weeks,3 weeks and 4 weeks,we randomly select 3 canines to observe regeneration of prostate urethra wound under cystoscope.After surgery,the bladder,prostate and prostate distale urethra were removed to make specimen and measure the diameter size of prostate.The HE staining and immunohistochemistry was performed in each sample.Results The experimental operation time was (70.5 ± 18.3) min (ramging 50-90 min).The average anesthesia time was (120.1 ± 21.1) min (ranging 95-145 min).The survival rate was 100％.In post surgery duration first standing time,first eating time,first drinking water time,first defecation time were (6.5 ± 1.8) h,(10.3 ± 2.1) h,(23.7 ± 5.6) h,(26.3 ± 3.1) h,respectively.The time when canine bladders rinse became clear and wound healing time were (5.2 ± 1.6) d,(8.7 ± 1.5) d respectively.Cystoscopy observated that the wound was covered by pale necrotic tissue 3 d and 1 week after operation,covered by epithelium 2 weeks after operation,covered by more thicker epithelium 3 weeks after operation,covered by epithelium which color was close to normal urothelium 4 weeks after operation.HE staining observated that the wound wasn't covered by epithelium 3 d after operation,partial wound was covered by flaky single or 2-3 cubic regenerated epithelial 1 week after operation,all wound was covered by epithelial which was lack of polar 2 weeks after operation,wound was covered by polarity epithelium which was thicken to 5-6 layer and observated a little umbrella cells on the surface 3 weeks after operation,wound was covered by polarity epithelium which was thicken to 5-6 layer and observated much umbrella cells on the surface 4 weeks after operation.Immunohistochemical staining observated that urinary spot protein from the wound or epithelium was negative 3 d,1 and 2 weeks after operation,urinary spot protein from the part of epithelium was positive 3 weeks after operation,and urinary spot protein from all epithelium was positive 4 weeks after operation.Conclusion It is feasible to establish prostate urethral re-epithelialization model in the Chinese rural canine by 2 μm laser vaporization resection of the prostate.
RESUMO
Objective To investigate and compare the clinical effects of 2-micron laser vaporization resection of prostate (2-micron laser) and versus transurethral resection of prostate (TURP) for treatment of benign prostatic hyperplasia(BPH) in this prospective random control study.Methods Sixty patients of BPH were randomly divided into two groups including the 2-micron laser group (n =30) and the TURP group (n =30).The perioperative markers and therapeutic results including duration of surgery,blood lose during surgery,improvement of symptoms after treatment,postoperative bladder washing time,the mean bladder irrigating time,hospital stay time,and recent complications were recorded and analyzed.Results The international prostate symptom score((6.6 ± 1.8) vs.(33.2 ±2.2),(5.7 ± 1.3) vs.(33.4 ±2.3) respectively),maximal urinary flow((20.6 ± 1.5) ml/s vs.(7.8 ± 4.3) m/s,(19.5 ± 1.7) ml/s vs.(8.3 ± 4.5) ml/s respectively),residual urine volume((22.3 ±4.7) ml vs.(57.2 ± 10.5) ml,(26.3 ±7.2) ml vs.(60.2 ± 14.5) ml respectively) were significantly improved in both groups after operation (P =0.005,0.008,0.036,0.001,0.005,0.013 respectively),but the differences between these two groups were not significant (P =0.16,0.49,0.97 respectively).The volume of hemorrhage ((20.9 ± 12.1) ml vs.(55.3 ± 27.8) ml),the mean bladder irrigating time ((1.0 ±0.5) d vs.(3.5 ±0.7) d),cathererization time ((3.2 ± 1.3) d vs.(6.0 ± 1.5) d),hospital stay time ((6.8 ±0.7) d vs.(10.6 ±0.6) d) were significantly less or shorter in the 2-micron laser group than in the TURP group (P =0.009,0.005,0.035,0.03 respectively).There was no significant difference in rates of complications between the two groups (P ＞ 0.05).Conclusion The therapy of 2-micron laser is safer and more efficacious than TURP for BPH patients,with advantages of short surgery duration,little blood loss,and quick recovery.