目的:探讨犁状电极等离子前列腺剜除术对不同体积良性前列腺增生(benign prostatic hyperplasia,BPH)患者的安全性、有效性和性功能的影响.方法:选取2022年2月—2023年4月就诊于合肥市第二人民医院行犁状电极等离子前列腺剜除术的78例BHP患者.根据患者前列腺体积大小分为A、B 2组,其中A组41例,前列腺体积为30～80 mL;B组37例,前列腺体积＞80 mL.比较2组前列腺体积大小、血红蛋白值、术后排尿情况等指标.结果:A组的手术时间较B组更短[(1.20±0.51)h vs(1.79±0.59)h,P＜0.05].2组血红蛋白丢失量、术后膀胱冲洗时间、导尿管留置时间、术后住院时间比较均差异无统计学意义(P＞0.05).2组患者术后3个月最大尿流率比较差异无统计学意义[(19.27±2.72)mL/s vs(18.52±1.88)mL/s,P＞0.05].2组患者术后国际前列腺症状评分(international prostate symptom score,IPSS)、生活质量评分(quality of life score,QOL)均较前改善,术后 3 个月时 2 组间的 IPSS[(5.61±1.18)vs(5.97±1.21),P＞0.05]、QOL[(1.76±0.89)vs(1.78±0.71),P＞0.05]比较均差异无统计学意义,2组患者术前国际勃起功能指数评分(in-ternational index of erectile function-5,IIEF-5)比较差异有统计学意义[(17.37±1.41)vs(15.46±1.45),P＜0.05],术后较术前有所提升,术后2组比较差异无统计学意义[(18.68±1.89)vs(18.30±1.27),P＞0.05].2组并发症发生率比较差异无统计学意义(P＞0.05),A组拔除导尿管时尿失禁3例(7.3％),术后3个月随访时无尿失禁患者,尿道狭窄1例(2.4％);B组拔除导尿管时尿失禁5例(13.5％),术后3个月随访时仍有2例尿失禁患者(5.4％),尿道狭窄1例(2.7％).结论:犁状电极等离子前列腺剜除术对不同体积BPH均具有良好的治疗效果,手术并发症并未随前列腺体积增大而增加.在明显改善患者的排尿困难症状的基础上,对勃起功能也有一定程度改善,该术式具有良好的安全性和有效性,有助于患者的早期恢复.
Effects of transurethral plasma enucleation with plough-shaped electrode on the efficacy and sexual function in benign prostate hyperplasia patients of diverse prostate volumes
Objective:To investigate the effects of transurethral plasma enucleation with plough-shaped elec-trode on the safety,efficacy and sexual function of patients with different volumes of BPH.Methods:The study comprised 78 patients who underwent transurethral plasma enucleation with plough-shaped electrode from Febru-ary 2022 to April 2023 at the Second People's Hospital of Hefei,categorized based on prostate size into Group A(prostate volume of 30 mL to 80 mL,n=41)and Group B(prostate volume greater than 80 mL,n=37).Pros-tate volume size,hemoglobin value,postoperative urination and other indexes between the two groups were com-pared.Results:The operative time was significantly shorter for Group A compared to Group B([1.20±0.51]h vs[1.79±0.59]h,P＜0.05).No significant differences were observed between the two groups regarding decrease in hemoglobin,duration of postoperative bladder irrigation,catheterization,or postoperative hospital stay(P＞0.05 for all comparisons).Three months postoperatively,the difference in Qmaxbetween the two groups was not statistically significant([19.27±2.72]mL/s vs[18.52±1.88]mL/s,P＞0.05).Both groups demonstrated im-provements in post-surgery IPSS and QOL scores,with no significant difference between them at the three-month follow-up:(5.61±1.18 vs 5.97±1.21,P＞0.05),(1.76±0.89 vs 1.78±0.71,P＞0.05).Although preoper-ative IIEF-5 scores significantly differed between the groups(17.37±1.41 vs 15.46±1.45,P＜0.05),postoper-ative improvements diminished this difference,making it statistically insignificant(18.68±1.89 vs 18.30±1.27,P＞0.05).There was no statistically significant difference in the incidence of complications between the two groups(P＞0.05).There were 3 cases(7.3％)of urinary incontinence at the time of catheter removal in group A,no patients with urinary incontinence and 1 case(2.4％)of urethral stenosis at the 3-month follow-up.In group B,there were 5 cases(13.5％)of urinary incontinence at the time of catheter removal,and there were still 2 cases(5.4％)of urinary incontinence and 1 case(2.7％)of urethral stenosis at the 3-month follow-up.Conclusion;Transurethral plasma enucleation with plough-shaped electrode is highly effective for treating benign prostatic hy-perplasia across a spectrum of prostate volumes,without escalating the risk of surgical complications.It markedly improves urinary distress and has a positive effect on erectile function.This technique proves to be both safe and efficacious,promoting swift post-surgery recovery.
prostatic hyperplasiaplough-shaped electrodeenucleation of the prostatesexual function
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