The clinical application of transurethral columnar balloon dilation for treating benign prostatic hyperplasia / 中华泌尿外科杂志

ABSTRACT

Objective:To evaluate the clinical efficacy and safety of transurethral columnar balloon dilation of prostate (TUCBDP) in treatment of patients with benign prostatic hyperplasia(BPH).Methods:A retrospective analysis was performed on 25 cases of BPH treated by TUCBDP in the First Affiliated Hospital of Anhui Medical University from June 2016 to July 2018. The median age was 80(57-94) years, and the median volume of prostate was 75 (30-176) ml. The median preoperative maximum urine flow rate (Q max) was 6 (2-9) ml/s, the median quality of life score (QOL)was 4(3-5) points. The median preoperative international prostate symptom score (IPSS) and residual urine volume (RUV) was 25(18-34) and 85 (30-510) ml respectively.The median preoperative international index of erectile function questionnaire-5 (IIEF-5) score was 11(5-21)points and the median preoperative premature ejaculation diagnostic tool (PEDT) score was 10(6-17)points.The standard procedure of TUCBDP includes injecting 5ml of normal saline into the inner capsule, touching the inner capsule at the apex of prostate, fixing the catheter and then injecting water into the outer capsule to make the pressure reach 2.5 kPa. When the pressure of the outer capsule was maintained at 3 kPa for 5 minutes, the prostate was split. The peroperative IPSS, QOL, Q max and RUV was compared. The IIEF-5 and PEDT score before and after surgery were compared in patients with normal sexual activity to evaluate whether there were reverse ejaculation and semen reduction. Results:One case of BPH failed to rupture and the other two cases was split at 6 o’clock. The three cases were converted to plasma resection. The rest 22 cases were operated successfully with the median operation time of 17(11-23)min, the hemoglobin loss of 19(15-22)g/L. The continuous bladder flushing time was 1(1-2)d, the indwelling catheter time was 10(7-11)d and the hospital stay time was 11(7-12)d. Twenty of 25 cases were followed-up for 12 months. IPSS was 8 (4-14) points, Q max was 17(9-25)ml/s, and RUV was 10 (0-150) ml; there were significant differences between the peroperative and postoperative (all P<0.001). The median QOL was 1(1-2) point, decreased than peroperative( P<0.05). No adverse ejaculation and semen reduction were found in the post-operative patients with normal sexual life. The post-operative IIEF-5 and PEDT score was 16 (7-24) points and 8 (6-14) points respectively, which was not significantly different while compared with pre-operative IIEF-5 and PEDT score. Conclusions:TUCBDP was proved to be effective and safe for treating high-risk BPH patients with the advantages of short operation time, less bleeding, significant improvement of residual urine and dysuria.