Clinical effect of transurethral plasmakinetic enucleation of the prostate combined with small suprapubic incision in the treatment of large benign prostatic hyperplasia complicated with bladder lithiasis
Li Bin, Lü Cai*, Liu Zhenxiang, Lei Qingqing
Department of Urology, Haikou Hospital Affiliated to Xiangya Medical College, Central South University, HaiKou 570208
Abstract：Objective: To investigate the efficacy of transurethral plasmakinetic enucleation of prostate （PKEP） combined with suprapubic small incision for bladder stone extraction in the treatment of large volume benign prostatic hyperplasia （BPH） complicated with bladder stones. Methods: From January 2017 to June 2019, 76 patients with BPH complicated with bladder stones due to lower urinary tract symptoms （LUTS） were selected in the Department of Urology, Haikou Hospital, Xiangya Medical College, South Central University. According to the treatment methods, the patients were divided into study group （n=36） and control group （n=40）. The study group was treated with PKEP combined with suprapubic small incision for bladder lithotomy, and the control group was treated with PKEP combined with transurethral holmium laser lithotripsy （THLL）. The preoperative, perioperative and postoperative indexes were compared between the two groups. Results: There was no significant difference in age, IPSS score, prostate volume, bladder stone load, Qmax, PSA and other baseline data between the two groups （P>0.05）. The study group had shorter operation time [（73.23±9.96） vs. （103.73±18.12）min], less intraoperative blood loss [（39.63±11.73）vs. （62.25±12.03）mL], greater weight of excised glands [（55.15±14.39）vs. （45.00±17.96）g], shorter postoperative bladder irrigation time [（1.38±0.54）vs.（1.88±0.72）d], and longer postoperative extubation time [（5.13±1.04）vs.（3.08±0.97）d] than the control group. The differences were statistically significant （P<0.05）. After 3-18 months of follow-up （mean 7.5 months）, there was no significant difference between the two groups in IPSS score, continence rate at 3rd month and incidence of postoperative urethral stricture. Conclusion: PKEP combined with small-incision bladder lithotomy is safe and effective. In the absence of tissue crusher, it can significantly save operation time, reduce intraoperative blood loss and not increase the risk of postoperative complications for patients with large volume BPH complicated with bladder stones, especially those with large stone load and unable to tolerate long-term operation.
李宾, 吕蔡, 刘振湘, 雷青青, 韩璐, 白志明. 经尿道前列腺等离子剜除术联合耻骨上小切口切开膀胱治疗大体积良性前列腺增生合并膀胱结石的疗效[J]. 微创泌尿外科杂志, 2022, 11(3): 189-193.
Li Bin, Lü Cai, Liu Zhenxiang, Lei Qingqing. Clinical effect of transurethral plasmakinetic enucleation of the prostate combined with small suprapubic incision in the treatment of large benign prostatic hyperplasia complicated with bladder lithiasis. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2022, 11(3): 189-193.
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