Abstract:Objective: To observe the midterm effect of photoselective vaporization of the prostate (PVP) on benign prostate hyperplasia (BPH) patients with midrange or serious IPSS score, and analyse the causes and treatment of postoperative adverse reactions. Methods: During the period between January 2010 and December 2012, 120 watt PVP surgery was performed on 160 cases of BPH with IPSS scores more than 16. The primary assessment included the following perioperative parameters: operative time, energy consumption, changes in hemoglobin, changes in serum salt concentration, urinary catheter indwelling time, hospital stay, etc., and complications during and after the operation. International Prostate Symptom Scoring (IPSS), the maximum urine flow rate test (Qmax) and the residual urine volume test (RUV) were conducted preoperatively and postoperatively for the patients. The average follow-up period was 12-24 months. The causes and the treatments of postoperative adverse reactions were analyzed. Results: There were 59 cases of moderate and 101 cases of severe IPSS基金项目:军队十二五课题(CWS11J061) 解放军307医院创新基金(FC-2014-06、ZH-2014-01)score, and the average IPSS score was (26.5±6.8). All the patients were safe in perioperation period, the operative time was 30-147 min, there was no intraoperative blood transfusion, and postoperative cather indwelling time was 2-5 days. Postoperative IPSS score, QOL score, and Qmax were increased significantly, RUV <30 mL. Patients were followed up for 12-24 months. During the follow-up period, 32 cases were not satisfied with the remission of lower urinary tract symptoms. Urodynamic studies and urinary tract endoscopy showed bladder outlet obstruction occurred in 25 cases, of which there were 22 cases of prostate gland residue, and 3 cases of bladder neck contracture, and detrusor atony in 6 cases (including 1 case of pseudodysuria), and 1 case of detrusor sphincter dyssynergia (DSD). Conclusions: PVP is an effective way for BPH patients with severe IPSS score. The surgical process is safe and effective, with less bleeding and less postoperative complications. IPSS score can assesst the effect of surgical results. Urodynamic studies can identify the reason of postoperative bad curative effectiveness, assess bladder function and detrusor muscle stability, which provides evidence for differential diagnosis, options of reasonable treatment, and estimation of prognosis.
麦海星,陈彪,陈立军,曲楠,赵立,王亚林,黄晨,李学超. 尿流动力学检查结合IPSS评分在分析BPH患者PVP术后疗效作用[J]. 微创泌尿外科杂志, 2015, 4(1): 23-26.
Mai Haixing, Chen biao, Chen Lijun, Qu Nan, Zhao Li,Wang Yalin, Huang Chen, Li Xuechao. Urodynamic studies combined with IPSS score for the analysis of curative effect of green laser surgery on BPH patients. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2015, 4(1): 23-26.
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