Comparative study on the efficacy and safety of diode laser enucleation and transurethral resection of prostate in the treatment of large-volume benign prostatic hyperplasia / 上海预防医学

ABSTRACT

Objective To compare the efficacy and safety of diode laser enucleation of prostate(DiLEP) and transurethral resection of prostate(TURP) in the treatment of large-volume benign prostatic hyperplasia(BPH).Methods A total of 80 cases of large-volume BPH patients who were treated in Shanghai Baoshan Traditional Chinese Medcine-integrated Hospital from January, 2014 to December, 2016 were selected.These patients were divided into two groups who were treated by DiLEP and TURP, respectively.The operation time, postoperative hemoglobin slippage, removed tissue weight, postoperative serum sodium slippage, postoperative complications, International Prostate Symptom Score (IPSS) before and after surgery, residual urine volume (PVR) and the maximum urinary flow-rate (Qmax),etc.of the two groups were compared.Results In the postoperative follow-up during 6 months after surgery, the IPSS before and after surgery, Qmax and Quality of Life (QOL) scores of the two groups showed no significant difference.The postoperative hemoglobin slippage, postoperative serum sodium slippage, vesical infusion time, urinary canal indwelling time and length of stay of the DiLEP group were all below those of the TURP group.The operation time (120.5±25.2)min vs(95±21.2)min;the quality of exercised tissues (68.5±16.2)g vs (65.2±18.5)g;the postoperative hemoglobin slippage (0.89±0.42)g/dL vs (1.24±0.56)g/dL;the postoperative serum sodium slippage (5.2±1.5)mmol/L vs (14.5±2.8)mmol/L;the vesical infusion time (28.5±5.9)h vs (48.5±6.7)h;the urinary canal indwelling time (2.6±1.8)d vs (4.8±2.2)d;the length of stay (6.2±1.8)d vs (9.2±2.3)d of both the DiLEP group and the TURP group all showed significant differences(all P<0.05).The postoperative complications, such as postoperative hemorrhage, postoperative blood transfusion, reset urethral catheterization, irritation symptoms, retrograde ejaculation, urinary incontinence, urethral stricture, electroresection syndrome, etc.of the two groups had significant differences(P<0.05).Conclusion For the treatment of large-volume BPH, DiLEP as compared with TURP, has less hemorrhage risks, requires less time in terms of vesical infusion time, urinary canal indwelling time and length of stay, has less postoperative complications, thus having good therapeutic effect and safety.