Effects of ttransurethral enucleationa resection of prostate on bladder function and sexual function of patients with large-volume benign prostatic hyperplasia
HUANG Yingqin1, LIU Shuang1, FAN Dongping1, WANG Yu1, HE Qiying1
1Department of Urology, West China Hospital of Sichuan University/Institute of Urology, Chengdu 610041, China
Abstract：Objective： To analyze the efficacy of transurethral enucleationa resection of prostate (TUERP) vs. transurethral resection of prostate (TURP) for large-volume benign prostatic hyperplasia (BPH) and their influence on bladder function and sexual functions. Methods： 121 cases of large-volume BPH were divided into TUERP group (n=65) and TURP group (n=56) according to the operation methods. The surgical conditions (operative time, intraoperative blood loss, bladder irrigation time, the weight of prostate resected, indwelling urinary catheter time, hospital stay) were compared between the two groups, and the incidence of surgical complications was counted. The maximum urinary flow rate (Qmax), post-voiding residual (PVR), International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), International Prostate Symptom Score (IPSS) and International Index of Erectile Function-5 score (IIEF-5) were measured before and 6 months after surgery. The effects of different surgical procedures on bladder function, urinary incontinence and sexual function of patients with large-volume BPH were analyzed. Results： The operative time, bladder irrigation time, indwelling urinary catheter time and hospital stay were significantly shorter, the intraoperative blood loss was significantly less, the weight of prostate resected was significantly heavier, and the incidence of total surgical complications was significantly lower in TUERP group than those in TURP group (all P<0.05). At 6th month after surgery, Qmax in the two groups was increased while PVR was decreased (P<0.05), and Qmax was significantly higher while PVR was significantly lower in TUERP group than those in TURP group (all P<0.05). At 6th month after surgery, the scores of IPSS and IIEF-5 in the two groups were decreased while the ICIQ-SF score was increased (P<0.05), and the IIEF-5 score in TUERP group was significantly lower than that in TURP group (P<0.05). At 6th month after surgery, the erectile dysfunction and retrograde ejaculation rate were increased in TURP group (P<0.05), and the erectile dysfunction and retrograde ejaculation rate in TUERP group were significantly lower than those in TURP group (P<0.05). Conclusion： The overall values of TUERP in the treatment of large-volume BPH is better than TURP, and TUERP has minimally invasion, little bleeding, few complications, small impact on sexual function, low incidence of urinary incontinence and good recovery of bladder function.
黄映勤, 刘爽, 范冬萍, 汪宇, 何其英. 经尿道等离子切除前列腺的膀胱功能及性功能的影响[J]. 微创泌尿外科杂志, 2019, 8(6): 415-420.
HUANG Yingqin, LIU Shuang, FAN Dongping, WANG Yu, HE Qiying. Effects of ttransurethral enucleationa resection of prostate on bladder function and sexual function of patients with large-volume benign prostatic hyperplasia. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2019, 8(6): 415-420.
[1] 张彦君,丁德刚,赵卫华.MRI结合肿瘤标志物在诊断前列腺癌中的应用.中国CT和MRI杂志,2018,16(7):124-126. [2] LIN Y, WU X, XU A, et al.Transurethral enucleation of the prostate versus transvesical open prostatectomy for large benign prostatic hyperplasia: a systematic review and meta-analysis of randomized controlled trials. World J Urol, 2016,34(9):1207-1219. [3] 朱明德,董焱鑫,高晓康,等.经尿道整体剜除与经尿道前列腺切除术治疗大体积前列腺增生的比较分析.中国内镜杂志,2016,22(11):66-70. [4] KAPLAN SA.Re: interactions between benign prostatic hyperplasia (BPH) and prostate cancer in large prostates: a retrospective data review. J Urol, 2017,197(6):1531-1532. [5] SOROKIN I, SUNDARAM V, SINGLA N, et al.Robotic assisted versus open simple prostatectomy for benign prostatic hyperplasia in large glands: a propensity score matched comparison of peri-operative and short-term outcomes. J Endourol, 2017,31(11):1164-1169. [6] BUSQUETS M, URQUIDI C, PERTOSSI E.Responsiveness of the chilean version of the International Consultation on Incontinence Questionnaire Short-Form (ICIQ-SF). Rev Med Chil, 2016,144(8):1006-1011. [7] MOREY AF.Re: the international prostate symptom score (IPSS) is an inadequate Tool to screen for urethral stricture recurrence after anterior urethroplasty. J Urol, 2017,197(5):1300-1301. [8] GANDAGLIA G, BRIGANTI A, SALONIA A, et al.Excellent erectile function recovery after focal therapy: is this enough? Eur Urol, 2016,69(5):852-853. [9] 娄彦亭,顾燕青,周业娟,等.经尿道前列腺等离子电切和剜除术的疗效及学习曲线分析.中国男科学杂志,2018,32(4):35-39. [10] WANG MQ, GUO LP, DUAN F, et al.Prostatic arterial embolization for the treatment of lower urinary tract symptoms caused by benign prostatic hyperplasia: a comparative study of medium- and large-volume prostates. BJU Int, 2016,117(1):155-164. [11] 黄国华. 前列腺炎合并前列腺增生患者前列腺液中IL-8、COX-2及MMP-9表达水平及意义.标记免疫分析与临床,2017,24(9):1043-1046. [12] 蒋茂林,曹正国,黎建欣,等.经尿道前列腺部分剜除联合等离子切除术在学习曲线内的应用体会.临床泌尿外科杂志,2018,33(3):217-219. [13] RAJEEV R, GIRI B, CHOUDHARY LP, et al.Surgery for benign prostatic hyperplasia: Profile of patients in a tertiary care institution. Natl Med J India, 2017,30(1):7-10. [14] ZENG QS, ZHAO YB, WANG BQ, et al.Minimally invasive simple prostatectomy for a case of giant benign prostatic hyperplasia. Asian J Androl, 2017,19(6):717-718. [15] GRIEBLING TL.Re: prostatic artery embolization for the treatment of symptomatic benign prostatic hyperplasia in men ≥ 75 years: a prospective Single-Center study. J Urol, 2018,199(1):11-12. [16] 罗有红,姚兆莉,温惠莉,等.经尿道等离子前列腺切除患者术后尿路感染的影响因素分析.中华医院感染学杂志,2018,28(16):2514-2517. [17] ALAWAMLH OA, GOUELI R, LEE RK.Lower urinary tract symptoms, benign prostatic hyperplasia, and urinary retention. Med Clin North Am, 2018,102(2):301. [18] 薛亚辉,宫小勇,郑伟,等.经尿道双极等离子前列腺剜除术对前列腺增生症的治疗效果.安徽医学,2016,37(11):1418-1421. [19] 刘路,程帆,李浩勇,等.经尿道1470nm激光三叶法前列腺剜除术与等离子双极前列腺电切术的临床疗效比较.武汉大学学报(医学版),2018,39(5):809-812. [20] 王锋. 经尿道前列腺电切术与经尿道前列腺剜除术治疗大体积前列腺增生的安全性及有效性分析.实用医院临床杂志,2018,15(4):199-201. [21] 万齐福,宋洪飞,何安仁.经尿道前列腺等离子剜除术对良性前列腺增生患者性功能的影响分析.中国性科学,2017,26(4):8-10. [22] 蔡大伟,孔广起.等离子前列腺剜除联合经膀胱前列腺旋切治疗大体积前列腺增生.中国微创外科杂志,2018,18(5):419-421.
