Clinical study of plasmakinetic resection of prostate combined with preoperative short-term goserelin acetate injection for benign prostatic hyperplasia with high surgical risk
Pan Jiahua1, Chen Haige1, Chen Qi1, Chen Yonghui1, Sun Jie1, Cao Ming1, Xue Wei1, Huang Yiran1
1Department of Urology, Renji Hospital Affiliated to Shanghai Jiaotong University, School of Medicine,Shanghai,200127,China
Abstract：Objective:For benign prostatic hyperplasia (BPH) patients with relatively high anesthesia risk, a therapeutic procedure with shorter operative time and less blood loss is necessary. It has been demonstrated that the prostate volume and blood supply can be reduced effectively by luteinizing hormone-releasing hormone analogues with good clinical tolerance. Therefore, the aim of this study was to evaluate the clinical value of plasmakinetic resection of prostate (PKRP) combined with preoperative short-term goserelin acetate injection for such patients.Methods:Thirteen BPH patients with relatively high anesthesia risk were enrolled in a preoperative short-term treatment group(Group A). Another 13 patients without high anesthesia risk were recruited as the controls(Group B). (group A: PKRP combined with preoperative short-term goserelin acetate injection and group B: PKRP). The prostate volume, highest flow velocity, and vascular resistance were measured with transrectal B ultrasound before and after the preoperative short-term treatment in group A. International prostate symptom score, operating time, incidence of perioperative complications, postoperative serum sodium levels, decrease in hemoglobin, hospitalization duration and catheter indwelling time were recorded in both groups.Results:In group A, after the pretreatment with short-term goserelin acetate injection, the average prostate volume, prostate maximum blood flow rate and the prostate vascular resistance index decreased remarkably. In addition, the average operative time and blood loss were reduced more significantly in group A than those in group B. Furthermore, the surgical outcome was satisfactory and the long-term international prostate symptom score (IPSS) was also reduced remarkably in group A.Conclusions:For BPH patients with relatively high anesthesia risk, PKRP combined with the preoperative short-term injection of goserelin acetate is a safe and effective therapeutic strategy.
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