Abstract：Objective： To evaluate the clinical efficacy and safety of three lobes based transurethral greenlight vaporization and enucleation of the prostate （TVEP） for the treatment of benign prostatic hyperplasia （BPH）. Methods： A retrospective analysis was performed on 838 patients with BPH who underwent three lobes based TVEP （n=623） or transurethral resection of the prostate （TURP, n=215）. Between the two groups, there was no significant difference in preoperative clinical data, including the average age, prostate weight, international prostate symptom score （IPSS）, quality of life score （QOL）, maximum urinary flow rate （Qmax）, and postvoid residual urine （PVR） （P > 0.05）. The mean operative time, changes of hemoglobin and serum sodium before and after the operation, postoperative bladder irrigation, catheter indwelling duration, and hospital stay were recorded. In addition, the complications, pre- and 3 months post-operative IPSS, QOL, Qmax, and PVR were monitored. Results： The operation was completed successfully in both groups. In the TVEP group, patients received three lobes based TVEP in the middle and bilateral leaves of the prostate respectively. There was no significant difference in the mean operation time between the two groups （P > 0.05）. The changes of hemoglobin and serum sodium before and after the operation, postoperative bladder irrigation duration, catheter indwelling duration, hospital stay, and complication rate in the TVEP group were significantly reduced as compared with those in the TURP group （P < 0.05）. There was significant improvement of IPSS, QOL, Qmax, and PVR in the two groups at 3rd month after surgery, while no significant difference was found between the two groups （P > 0.05）. Conclusions： Three lobes based TVEP, which is simple and easy, is safe and effective for the treatment of BPH with a maximum excision of the hyperplastic prostate tissue. It is a minimally invasive surgery with better efficacy, less intraoperative bleeding, higher security, lower risk, and quicker recovery for the patients, which deserves to be popularized.
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