A comparative study on the clinical effects of 1470 nm diode laser vaporization and transurethral resection of the prostate for benign prostatic hyperplasia / 中国综合临床

ABSTRACT

Objective To compare the safety and efficacy of 1 470 nm diode laser vaporization of the prostate with transurethral resection of the prostate (TURP) in patients with benign prostatic hyperplasia (BPH).Methods From July 2014 to July 2015,82 patients diagnosed as BPH were randomly divided into two groups.Forty cases of them underwent 1 470 nm diode laser vaporization and 42 cases for TURP.The operation time,hemoglobin decrease,serum sodium decrease,bladder irrigation time,duration of bladder catheterization and postoperative complications were recorded.The international prostate symptom score (IPSS),maximum flow rate (Qmax) and post-voiding residual volume (PVR) before and after operation were compared.Results No differences were found between the two groups in basic preoperative characteristics,such asage,prostate volume,IPSS,PVR and Qmax(P＞0.05).The mean operative time in the diode laser group was (64.8±14.6) min,slightly longer than tin he TURP group ((59.3 ± 14.5) min,P＞0.05).The hemoglobin decrease,the serum sodium decrease,the time of bladder irrigating and the time of catheterization of 1470 nm diode laser group were all less than that in TURP group,the differences were significant between the two groups((2.06±1.43) g/L vs.(6.07±1.68) g/L,(1.16±0.67) mmol/L vs.(4.09±3.78) mmol/L,(5.08±2.80) h vs.(25.8±12.7) h,(3.38±1.17) d vs.(4.88± 1.42) d,respectively;t =-11.615,-4.845,-10.337,-5.232;P＜0.001).The complications in 1470nm diode laser group were less than that in TURP group,but the differences were not significant between the two groups(P＞0.05).All patients were followed up for 3-12 months,the IPSS,PVR and Qmax of 3 months after surgery in 1 470 nm diode laser group and TURP group were all improved significantly compared with that of preoperative in both groups,but no statistical differences could be found between the two groups(IPSSF inner grouP=527.65,P＜0.001;F between groups=0.099,P=0.753;F across groups=0.040,P=0.843,PVRF inner grouP =509.57,P＜ 0.001;F between groups =2.817,P =0.097;F across groups =1.02,P=0.315;Qmaxinner grouP=60.06,P＜0.001;F between groups =0.30,P=0.585;F across groups =0.394,P=0.532).Conclusion 1 470 nm diode laser vaporization of the prostate can significantly improve the patient's lower urinary tract obstruction symptoms,which show similar short-term effects with TURP.It also has advantages of less bleeding,shorter catheter indwelling time and rapid postoperative recovery compared with TURP,suggesting that it is a safe and effective operation for BPH treatment.