Abstract：
OBJECTIVE: The occurrence of prostate hyperplasia has increased remarkedly, especially in elderly patients; However, research on which surgical treatment is effective and safe for benign prostatic hyperplasia (BPH) in elderly people over 70 years old is limited. This study aimed to investigate the clinical efficacy and safety of transurethral plasma kinetic prostatectomy (TUPKP) and holmium laser enucleation of prostate (HoLEP) as a therapy for benign prostatic hyperplasia (BPH) in the elderly.
METHODS: A total of 148 patients with BPH admitted from December 2022 to December 2023 were chosen and divided into HoLEP (n = 74) and TUPKP (n = 74) groups according to the surgical operation. Perioperative related indexes, preoperative and postoperative international prostate symptom scores and life quality scores were compared between the two groups. The postoperative complications were also counted for the two groups.
RESULTS: The HoLEP group had lower intraoperative bleeding, mean operative time, catheter indwelling time and hospital stays than the TUPKP group (p < 0.001). Before treatment, no significant difference in prostate symptom scores was found between the two groups (p > 0.05). After treatment, the prostate symptom scores in the HoLEP group were significantly lower than those in the TUPKP group (p < 0.001). However, the maximum urinary flow rate was significantly higher (p < 0.001) and the residual urine volume was significantly lower (p < 0.001) in the HoLEP group than in the TUPKP group after operation. The complication rate in the TUPKP group was 25.66%, which was significantly higher than the 9.46% in the HoLEP group (p < 0.05). The life quality scores of the HoLEP group were higher than those of the TUPKP group (p < 0.001).
CONCLUSIONS: HoLEP for BPH therapy is effective and safe with low incidence of postoperative complications.
METHODS: A total of 148 patients with BPH admitted from December 2022 to December 2023 were chosen and divided into HoLEP (n = 74) and TUPKP (n = 74) groups according to the surgical operation. Perioperative related indexes, preoperative and postoperative international prostate symptom scores and life quality scores were compared between the two groups. The postoperative complications were also counted for the two groups.
RESULTS: The HoLEP group had lower intraoperative bleeding, mean operative time, catheter indwelling time and hospital stays than the TUPKP group (p < 0.001). Before treatment, no significant difference in prostate symptom scores was found between the two groups (p > 0.05). After treatment, the prostate symptom scores in the HoLEP group were significantly lower than those in the TUPKP group (p < 0.001). However, the maximum urinary flow rate was significantly higher (p < 0.001) and the residual urine volume was significantly lower (p < 0.001) in the HoLEP group than in the TUPKP group after operation. The complication rate in the TUPKP group was 25.66%, which was significantly higher than the 9.46% in the HoLEP group (p < 0.05). The life quality scores of the HoLEP group were higher than those of the TUPKP group (p < 0.001).
CONCLUSIONS: HoLEP for BPH therapy is effective and safe with low incidence of postoperative complications.
摘要：
目的：前列腺增生的发生率明显增加，尤其是老年患者；然而，关于70岁以上老年人良性前列腺增生（BPH）的手术治疗有效和安全的研究有限。本研究旨在探讨经尿道前列腺等离子电切术(TUPKP)联合钬激光前列腺摘除术(HoLEP)治疗老年良性前列腺增生(BPH)的临床疗效及安全性。
方法：选择2022年12月至2023年12月收治的148例BPH患者，根据手术方式分为HoLEP组（n=74）和TUPKP组（n=74）。围手术期相关指标,比较两组患者术前、术后国际前列腺症状评分和生活质量评分。同时统计两组术后并发症。
结果：HoLEP组术中出血量较低，平均手术时间，导管留置时间和住院时间均优于TUPKP组(p<0.001)。治疗前,两组间前列腺症状评分差异无统计学意义(p>0.05)。治疗后,HoLEP组的前列腺症状评分明显低于TUPKP组(p<0.001).然而,术后HoLEP组的最大尿流率显著高于TUPKP组(p<0.001),残余尿量显著低于TUPKP组(p<0.001)。TUPKP组并发症发生率为25.66%,显著高于HoLEP组的9.46%(p<0.05)。HoLEP组的生活质量评分高于TUPKP组(p<0.001)。
结论：HoLEP治疗BPH安全有效，术后并发症发生率低。
方法：选择2022年12月至2023年12月收治的148例BPH患者，根据手术方式分为HoLEP组（n=74）和TUPKP组（n=74）。围手术期相关指标,比较两组患者术前、术后国际前列腺症状评分和生活质量评分。同时统计两组术后并发症。
结果：HoLEP组术中出血量较低，平均手术时间，导管留置时间和住院时间均优于TUPKP组(p<0.001)。治疗前,两组间前列腺症状评分差异无统计学意义(p>0.05)。治疗后,HoLEP组的前列腺症状评分明显低于TUPKP组(p<0.001).然而,术后HoLEP组的最大尿流率显著高于TUPKP组(p<0.001),残余尿量显著低于TUPKP组(p<0.001)。TUPKP组并发症发生率为25.66%,显著高于HoLEP组的9.46%(p<0.05)。HoLEP组的生活质量评分高于TUPKP组(p<0.001)。
结论：HoLEP治疗BPH安全有效，术后并发症发生率低。
