Effect of 1 470nm laser anterograde enucleation on BPH and its influence on stress response and quality of life / 中国基层医药

ABSTRACT

Objective:To observe the effect of 1 470nm laser anterograde enucleation on benign prostatic hypertrophy (BPH), and its influence on stress response and quality of life.Methods:From July 2018 to May 2019, 90 patients with BPH diagnosed and treated by urology department in Rizhao Central Hospital were selected in the study.According to the different treatment methods, they were divided into two groups, with 45 cases in each group.In the observation group, 1 470nm laser anterograde enucleation of prostate was used.The control group was treated with transurethral plasma resection.The operation time, bladder flushing time, indwelling catheter time and hospitalization time of the two groups were compared.The stress responses of the two groups were compared, including CK, CRP, cortisol and adrenaline levels.The differences of IPSS score, QOL score, maximum urine flow rate (Qmax) and residual urine test (PVR) between the two groups were compared after 6 months of follow-up.The incidence of complications of the two groups was compared.Results:The operation time of the observation group was significantly longer than that of the control group[(80.2±23.5)min vs.(69.5±19.2)min], and the bladder washing time[(1.4±0.3)d vs.(1.7±0.4)d], indwelling catheter time[(5.2±0.9)d vs.(6.2±1.1)d] and hospitalization time[(6.7±1.1)d vs.(8.3±1.6)d] were significantly shorter than those of the control group ( t=4.576, 4.025, 4.719, 5.528, all P<0.05). After operation, the levels of CK[(100.5±11.5)U/L vs.(86.5±9.2)U/L, (103.5±15.4)U/L vs.(87.3±9.9)U/L], CRP[(14.5±2.9)mg/L vs.(12.5±2.5)mg/L, (16.3±3.1)mg/L vs.(12.6±1.9)mg/L], cortisol[(285.2±45.6)ng/mL vs.(235.6±36.5)ng/mL, (310.2±55.6)ng/L vs.(241.6±43.2)ng/L] and adrenaline[(57.8±8.7)pg/mL vs.(51.5±7.8)pg/mL, (62.5±9.9)pg/L vs.(50.9±8.9)pg/L] in the two groups were significantly higher than those before operation ( t=6.377, 6.478, 3.504, 5.125, 5.696, 6.752, 3.617, 4.992, all P<0.05). The levels of CRP, cortisol and adrenaline in the observation group were significantly lower than those in the control group (all P<0.05). After operation, the IPSS score[(7.5±1.6)points vs.(24.2±6.8)points, (7.7±1.9)points vs.(23.8±7.6)points] and QOL score[(1.4±0.5)points vs.(5.0±0.6)points, (1.6±0.6)points vs.(4.9±0.7)points] of the two groups were significantly reduced, Qmax[(21.7±3.5)mL/s vs.(7.5±2.1)mL/s, (22.1±4.3)mL/s vs.(7.8±2.5)mL/s] were significantly increased, PVR[(28.6±7.2)mL vs.(111.2±26.5)mL, (29.3±8.1)mL vs.(114.5±32.5)mL] were significantly increased, the differences were statistically significant ( t=16.037, 14.251, 30.920, 27.528, 23.338, 22.527, 20.178, 21.852, all P<0.05), but there were no statistically significant differences between the two groups (all P>0.05). There was no significant difference in the incidence of postoperative complications between the two groups ( P>0.05). Conclusion:1 470nm laser anterograde enucleation of prostate is a reliable method for the treatment of BPH.