摘要
目的探讨经尿道双极等离子前列腺剜除术(PKERP)保留前列腺尖尿道黏膜治疗良性前列腺增生症的疗效及对于保留尿控功能的优势。方法 2014年1月至2016年1月,220例良性前列腺增生症患者随机采用常规的PKERP与保留黏膜的PKERP,各110例。比较分析两组的手术时间、术中出血量、前列腺切除量、膀胱持续冲洗时间、手术疗效及手术并发症。结果两组间的一般资料、手术时间、术中出血量和膀胱持续冲洗时间差异均无统计学意义(P>0.05);两组的术后国际前列腺症状评分、生活质量评分及最大尿流率均显著改善(P<0.05);对比而言,保留黏膜PKERP组的术后暂时性尿失禁发生率(43.6%vs 28.2%)及拔除尿管后出现膀胱过度活动症的发生率(33.7%vs 18.2%)均明显改善,差异有统计学意义(P<0.05)。进一步对前列腺体积分层分析,对于大体积前列腺(≥80g),保留黏膜PKERP组的术后暂时性尿失禁发生率低于常规PKERP组(57.6%vs 28.6%,P<0.05),而<80g的前列腺,两组术后暂时性尿失禁发生率尚不能认为有统计学差异(39.3%vs 28.1%,P>0.05)。结论保留黏膜PKERP治疗良性前列腺增生症的短期疗效与常规的PKERP相同,既不增加手术时间、术中出血量、包膜穿孔率,又可有效减少术后暂时性尿失禁发生率,特别是对于大体积的前列腺,对于保留尿控功能具有一定的优势。
Objective To evaluate the clinical efficacy and advantage of urinary continence after transurethral bipolar plasmakinetic enucleation and resection of the prostate（PKERP）with reservation of the partial urethral mucosa for benign prostatic hyperplasia（BPH）. Methods Totally 220 patients from January 2014 to January 2016 were randomly divided into groups of PKERP with partial urethral mucosa reservation（MR-PKERP）（n=110）and conventional PKERP（C-PKERP）（n=110）.Efficacy of the two groups was evaluated respectively 3-6months after surgery.Comparisons were made between the two groups in operative time,blood loss volume,resected prostatic tissue weight,continuous irrigation of bladder time and complications. Results All the base parameters,operative time,blood loss volume,resected prostatic tissue weight and continuous irrigation of bladder time between the two groups had no statistically significant difference（P〈0.05）.The postoperative international prostate symptom score（IPSS）,quality of life（QOL）and average maximun urinary flow（Qmax）improved significantly（P〈0.05）.Temporary urinary incontinence（43.6% vs28.2%）and overactive bladder（OAB）（33.7% vs 18.2%）after surgery in MR-PKERP were less than C-PKERP with significant differences（P 0.05）.Temporary urinary incontinence improved significantly in the two groups as for≥80g weight prostate（57.6% vs 28.6%,P〈0.05）,but no significant difference in the two groups as for80g weight prostate. Conclusions MR-PKERP is safe and effective as C-PKERP for BPH treatment with no difference in operative time,blood loss volume,and capsule perforation,and it can improve urinary continence of C-PKERP,especially for large volume prostatic hyperplasia case.
出处
《现代泌尿生殖肿瘤杂志》
2016年第6期350-354,共5页
Journal of Contemporary Urologic and Reproductive Oncology
关键词
前列腺增生
前列腺剜除术
尿失禁
Prostatic hyperplasis
Enucleation of the prostate
Urinary incontinence
