Abstract：Objective: To discuss the efficiency and safety of transurethral vapor enucleation of prostate with TURis button electrode. Methods: During May 2015 to January 2017, 57 patients were given transurethral vapor enucleation of prostate with TURis button electrode plus tissue morcellator in our hospital. The operation time, time of tissue morcellator, the decline of hemoglobin concentration, the weight of resected tissue, time of irrigation, catheterization period and perioperative complications were recorded. The changes of IPSS, QOL, Qmax, and PVR were compared before and 6 months after operation. Results: All the 57 patients received general anesthesia. The mean operative duration was (83.6±29.2) min (65-178 min), the mean decline of hemoglobin concentration was (1.3±0.2) g/L(0.1-2.7 g/L), the mean weight of resected tissue was (43.8±12.4) g (35-67 g), the mean irrigating duration was (26.2±11.6) h (11-58 h), and the mean catheterization period was (4.5±1.4) days (3-8 days). Six months after the operation, the IPSS, Qmax, QOL and PVR were improved significantly as compared with those before operation. The mucosal bladder injury occurred in 2 patients, and treated accordingly. Short-term incontinence occurred in one patient, and recovered 6 weeks after operation. No sever complication was observed. Conclusions: Transurethral vapor enucleation of prostate with TURis button electrode plus tissue morcellator is a safe and effective method in the treatment of benign prostatic hyperplasia.
[1] Van Asseldonk B, Barkin J, Elterman DS. Medical therapy for benign prostatic hyperplasia: a review. Can J Urol, 2015,22(Suppl 1):7-17. [2] de la Rosette J, Alivizatos G, Madersbacher S, et al. EAU guidelines on benign prostate hyperplasia (BPH). Eur Urol, 2001,40(3):256-263. [3] 谢立平,陈弘.前列腺增生腔内剜除手术的优化——经尿道前列腺汽化剜切术/剜除术(附光盘).现代泌尿外科杂志,2016,21(12):901-903. [4] Madersbacher S, Alivizatos G, Nordling J, et al. EAU 2004 guidelines on assessment, therapy and follow-up of men with lower urinary tract symptoms suggestive of benign prostatic obstruction (BPH guidelines). Eur Urol, 2004,46(5):547-554. [5] 郑少波,刘春晓,徐亚文,等.腔内剜除法在经尿道前列腺汽化电切术中的应用.中华泌尿外科杂志,2005,26(8):558-561. [6] Tan AH, Gilling PJ, Kennett KM, et al. A randomized trial comparing Holmium laser enucleation prostate with transurethral resection of the for the treatment of bladder outlet obstruction secondary to benign prostatic hyperplasia in large glands(40 to 200 grams). J Urol, 2003,170(4 Pt 1):1270-1274. [7] Tan A, Liao C, Mo Z, et al. Meta-analysis of Holmium laser enucleation versus transurethral resection of the prostate for symptomatic prostatic obstruction. Br J Surg, 2007,94(10):1201-1208. [8] McVary K, Roehrborn C, Avins A, et al. Update on AUA Guideline on the Management of Benign Prostatic Hyperplasia. J Urol, 2011,185(5):1793-1803. [9] Chen YB, Chen Q, Wang Z, et al. A prospective, randomized clinical trial comparing plasmakinetic resection of the prostate with Holmium laser enucleation of the prostate based on a 2-year followup. J Urol, 2013,189(1):217-222. [10] Krambeck AE, Handa SE, Lingeman JE. Experience with more than 1,000 Holmium laser prostate enucleations for benign prostatic hyperplasia. J Urol, 2010,183(3):1105-1109. [11] Fayad AS, Sheikh MG, Zakaria T, et al. Holmium laser enucleation versus bipolar resection of the prostate: a prospective randomized study. Which to choose? J Endourol, 2011,25(8):1347-1352. [12] Elshal AM, Mekkawy R, Laymon M, et al. Towards optimizing prostate tissue retrieval following Holmium laser enucleation of the prostate(HoLEP): assessment of two morcellators and review of literature. Can Urol Assoc J, 2015,9(9-10):E618-E625. [13] Mcadams S, Nunez-Nateras R, Martin CJ, et al. Morcellation efficiency in Holmium laser enucleation of the prostate: oscillating morcellator outperforms reciprocating morcellator with no apparent learning curve. Urology, 2017,106:173-177.
