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Objective To evaluate the safety and efficacy of bipolar transurethral plasmakinetic enucleation of the prostate (PKEP) with PKRP for benign prostatic hyperplasia (BPH) with prostate volumes over 80 ml.Methods A total of 78 patients of BPH with prostate volume more than 80 ml were retrospectively analysed to either PKEP (n =41) or PKRP (n =37).All patients were assessed preoperatively and followed up of clinic at the 3rd,6th,and 12 th month postoperatively.Baseline characteristics of the patients,intraoperative events (operation time,bleeding volume),postoperative events (bladder irrigation time,catheter time) and postoperative effect evaluation (IPSS score,QOL score and Qmax) were recorded.t test was used for measurement data expressed by ((x) ± s) among groups.And chi-square test was used for Enumeration data expressed by rate(％) between the two groups.Results The operation time,the decrease of hemoglobin,irrigation time and the catheter time in the PKEP and PKRP were (100.7 ±31.2),(150.1 ±30.3) min,(1.1 ±0.5),(2.1 ±0.8) g/dl,(16.9 ±4.3),(31.8 ± 8.3) h,(33.4 ± 11.2),(51.7 ± 18.6) h,respectively.Those indexes in the PKEP group were significantly better than those in the PKRP group (P ＜ 0.05).The baseline values and postoperative outcome indices of PKEP group at the 3rd,6th,and 12 th month were IPSS (28.01 ± 5.31),(15.01 ± 3.62),(8.01 ±2.30),(7.83±2.11)、QOL(4.5 ±0.8),(3.5 ±0.6),(1.3 ±0.4),(1.1 ±0.5)、Qmax(6.21 t2.09),(13.24 ± 2.31),(15.33 ± 2.44),(17.65 ± 3.21) mL/s,residual urine volume (75.02 ± 25.21),(10.87 ±6.16),(10.55 ± 5.21),(9.97 ± 5.63) ml.All the indices after 3 months of operation were improved compared with baseline values (P ＜ 0.05).The incidence of complications in PKEP group (17.1 ％,7/41) was lower than that in PKRP group (27.0％,10/17) (P =0.288).Conclusion PKEP is a safe and efficient treatment of BPH patients with prostate volume more than 80 ml.Compared with PKRP,PKEP provides less risk of hemorrhage and shorter catheter time,the operation time,irrigation time.
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Objective To investigate the clinical effect of the 1 470 nm diode laser for the treatment of superficial bladder tumor.Methods Two hundreds and sixteen patients diagnosed with superficial bladder tumor were treated in our hospital from January 2012 to January 2014 and divided into the laser group and electric cutting group.The two groups were treated by 1 470 nm diode laser and transurethral plasma kinetic resection respectively.The basic data and the observation indexes were compared be tween the two groups.Results The operation time,intraoperative bleeding volume,indwelling catheter time and hospital stay time in the laser group were significantly less than those in the electric cutting group.The levels of epinephrine,norepinephrine and an giotensin Ⅱ in operation and at postoperative 6 h in the laser group were significantly lower than those in the electric cutting group (P＜0.05).The obturator nerve reflex and bladder perforation did not occur in the laser group,and the total complications occurrence rate was 5.1％,the bladder tumor recurrence rate in postoperative 24 months was 7.1％.The obturator nerve reflex occurrence rate was 7.6％,the vesical perforation rate was 1.7％,the total complications occurrence rate was 15.3％,the bladder tumor recurrence rate in postoperative 24 months was 17.8 ％ in the electric cutting group.The above indexes of the laser group were significantly lower than those of the electric cut group(P＜0.05).Conclusion The 1 470 nm diode laser for the treatment of noninvasive superficial bladder tumor has definitely curative effect,is easy to operate with low postoperative complication occurrence rate,high safety and low middle and long term recurrence rate,moreover has little influence on patient's stress level.
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Objective To evaluate the short-term safety and efficacy of transurethral plasma kinetic enucleation of the prostate (PKEP)for benign prostatic hyperplasia (BPH)larger than 60 ml. Methods A retrospective analysis was carried out on clinical data and treatment outcomes of 87 cases of BPH with prostate volume larger than 60 ml in Fuzhou General Hospital of Nanjing Military Command from September 2013 to August 2015.The patients were divided into either PKEP group (45 cases)or plasma kinetic resection of prostate (PKRP)group (42 cases).The operation time,resected adenoma weight,decline in hemoglobin 1 day after operation,and catheterization and irrigation duration were recorded and analyzed.The international prostate symptom score (IPSS), quality of life score (QOL),post-void residual urine volume (PVR),maximum urinary flow rate (Qmax)before surgery and 1 ,3,6 months after operation respectively were evaluated. Results As compared with the PKRP group,the PKEP group excelled in greater resected prostate weight [(52.4 ±15.2)g vs.(40.0 ±14.1 )g,t =3.94,P =0.00],less decline in hemoglobin [(9 ±4)g /L vs. (17 ±6)g /L,t =-7.36,P =0.00],shorter irrigation duration [(1 .1 ±0.3)d vs.(1.4 ±0.5)d,t =-3.42,P =0.00],and shorter catheterization duration [(3.3 ±0.5)d vs.(5.5 ±0.5 )d,t =-20.50,P =0.00].There were no significant differences between the two groups in terms of operation time and operative complications such as transient incontinence and hematuria (P >0.05).Postoperative improvements in IPSS,QOL,PVR,and Qmax were similar between the two groups (P >0.05)but significantly improved as compared with before operation (P <0.05). Conclusion PKEP is a new,safe,and effective minimal invasive surgical option for the treatment of BPH larger than 60 ml.