Comparative study of the safety and efficacy between 1470nm laser enucleation of the prostate and transurethral resection of the prostate for benign prostatic hyperplasia with over 80 mL volume
WANG Wei1,2, PAN Tiejun2, GAO Lei2, LI Gongcheng2, WANG Tao2, LI Xiang2
1 First Clinical Medical College of Southern Medical University, Guangzhou 510515, China; 2 Department of Urology, Central War Zone General Hospital of Chinese People's Liberation Army
Abstract：Objective： To compare the safety and efficacy of the two surgical approaches, 1 470 nm laser enucleation of the prostate (LEP) versus transurethral resection of the prostate (TURP), in the treatment of benign prostatic hyperplasia with over 80 mL volume. Methods： From August 2017 to February 2019, 90 cases of BPH with over 80 mL volume were enrolled, including 45 cases undergoing LEP, and 45 cases receiving TURP. The operative time, the weight of resected gland, drop in hemoglobin and sodium ion, duration of postoperative bladder irrigation, indwelling catheterization time, hospital stay and the postoperative complications were recorded. IPSS, QOL, PVR and Qmax were also compared. Results： Patients in the LEP group displayed shorter operative time [(75.4±16.3) min vs. (96.2±17.4) min], lower risk of haemorrhage [(1.5±0.4) g/L vs. (4.6±1.2) g/L], lower sodium ion decrease [(1.8±0.5) g/min vs. (4.3±1.2) g/min], shorter bladder irrigation time [(1.5±0.4) d vs. (2.5±0.3)d] and shorter catheter indwelling time [(2.4±0.5) d vs. (4.6±1.2) d], as well as shorter hospital stays [(5.4±1.4) d vs. (7.6±1.5) d] (P < 0.05). The IPSS, QOL, PVR and Qmax were significantly improved after 3 months postoperatively in both groups, but there were no significant differences between the two groups (P > 0.05). Two cases required blood transfusion in the TURP group after operation, and none in the LEP group. TURS occurred in one case of the TURP group, and none in the LEP group. The incontinence presented in both groups (4 in the TURP group and 2 in the LEP group). Re-operations due to the urethral stricture and bladder neck contracture were needed in 1 case of the TURP group, and none in the LEP group. Conclusions： LEP is an excellent treatment for BPH with over 80 mL volume as well as TURP. However, compared with TURP, LEP has the advantages of shorter operative time, less risk of bleeding, rapid recovery, and lower incidence of complications.
王伟, 潘铁军, 高磊, 李功成, 王涛, 李想. 1 470 nm半导体激光前列腺剜除术与电切术治疗大体积前列腺增生疗效比较[J]. 微创泌尿外科杂志, 2020, 9(2): 130-134.
WANG Wei, PAN Tiejun, GAO Lei, LI Gongcheng, WANG Tao, LI Xiang. Comparative study of the safety and efficacy between 1470nm laser enucleation of the prostate and transurethral resection of the prostate for benign prostatic hyperplasia with over 80 mL volume. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2020, 9(2): 130-134.
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