经尿道前列腺电切术与经尿道双极等离子前列腺腔内剜除术的临床效果及其对患者性功能影响的对比分析

doi:10.3969/j.issn.1009-976X.2020.04.015

摘要/Abstract

摘要： 目的比较经尿道前列腺电切术（TURP）与经尿道双极等离子前列腺腔内剜除术（TPKEP）治疗前列腺增生患者的临床效果,并分析其对患者性功能的影响。方法选取我院2016年1月至2018年1月86例前列腺增生患者为研究对象,将实施经尿道双极等离子前列腺腔内剜除术的作为观察对象（TPKEP组,n=44）,将行经尿道前列腺电切术的患者作为对照组（TURP组,n=42）,收集两组患者的围手术数据和术后性功能状况资料并进行比较。结果 TPKEP组患者手术时间65.4±15.8 min、术中出血量231.3±77.5 mL及导管留置时间5.5±0.6 d,TURP组患者手术时间76.8±16.9 min、术中出血量346.2±81.4 mL及导管留置时间6.0±0.7 d,两组间的差异有统计学意义（P<0.05）。TPKEP组患者术后勃起功能障碍、逆行射精发生率低于TURP组患者（P<0.05）;两组患者术后射精痛和性欲下降的差异无统计学意义（P>0.05）。结论与TURP相比,TPKEP术中出血量较少,术后对BPH患者性功能的影响较小。

关键词: 前列腺增生, 治疗, 性功能

Abstract: Objective To investigate the sexual function and clinical changes of transurethral electroresection of the prostate and transurethral plasmakinetic enucleation of the prostate on patients with prostatic hyperplasia. Methods 86 patients with prostatic hyperplasia from January 2016 to January 2018 were selected and divided into two groups. The 42 patients in control group received transurethral electroresection and the 44 patients in the observation group received transurethral plasmakinetic enucleation of the prostate. The sexual function and clinical changes in related indicators was observed after treatment. Results In the observation group, operation time was 65.4±15.8 min, intraoperative blood loss was 231.3±77.5 ml and catheter indwelling time was 5.5±0.6 d. In control group, operation time was 76.8±16.9 min, intraoperative blood loss was 346.2±81.4 ml and catheter indwelling time （6.0±0.7） d, the observation group was better than the control group, the difference is statistically significant （P<0.05）. In observation of the group, the ED rate and the retrograde ejaculation rate were lower, the difference between the two groups has statistical significance （P<0.05）. Conclusion Compare with TURP, TPKEP has less intraoperative blood loss and no negative influence on the quality of sexual function.

Key words: sexual function, prostatic hyperplasia, treatment

中图分类号:

R697+.3

冯传顺, 刘云飞, 彭乃雄, 邓灵, 王细生. 经尿道前列腺电切术与经尿道双极等离子前列腺腔内剜除术的临床效果及其对患者性功能影响的对比分析[J]. 岭南现代临床外科, 2020, 20(04): 472-475.

FENG Chuan-shun, LIU Yun-fei, PENG Nai-xiong, DENG Ling, WANG Xi-sheng. Evaluation between transurethral electroresection of prostate and transurethral plasmakinetic enucleation of the prostate for patient with benign prostatic hyperplasia[J]. Lingnan Modern Clinics in Surgery, 2020, 20(04): 472-475.

参考文献

[1] Qi J, Yu YJ, Huang T, et al.Comparation of the predictive value between ultrasonography and urodynamics for the efficacy of transurethral resection of prostate in benign prostatic hyperplasia patients[J]. Chin Med J (Engl), 2012, 125(9): 1536-1541.
[2] Oelke M, Bachmann A, Descazeaud A, et al.EAU guidelines on the treatment and follow-up of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction[J]. Eur Urol, 2013, 64(1): 118-140.
[3] Rai P, Srivastava A, Singh S, Dhayal IR.Comparison of bipolar plasmakinetic transurethral enucleation and resection of prostate gland in patients receiving anticoagulants and/or platelet aggregation inhibitors[J]. Minerva Urol Nefrol, 2019, 71(3): 286-293.
[4] Jiang Y, Bai X, Zhang X, et al.Comparative Study of the Effectiveness and Safety of Transurethral Bipolar Plasmakinetic Enucleation of the Prostate and Transurethral Bipolar Plasmakinetic Resection of the Prostate for Massive Benign Prostate Hyperplasia (>80 ml)[J]. Med Sci Monit, 2020, 26: e921272.
[5] Gu M, Chen YB,Liu C, et al.Comparison of Holmium Laser Enucleation and Plasmakinetic Resection of Prostate: A Randomized Trial with 72-Month Follow-Up[J]. J Endourol, 2018, 32(2): 139-143.
[6] 程伟, 刘修恒, 陈明, 等. 经尿道双极等离子前列腺剜除术对良性前列腺增生尿道功能与性功能的影响[J]. 现代泌尿外科杂志, 2015, 20(12): 859-861.
[7] Li BK, Chen BS, Xin YH, et al.Can the low urinary tract storage symptoms be completely resolved after plasmakinetic enucleation of the prostate?[J]. Asian J Androl, 2017, 19(6): 655-658.
[8] Sun F, Sun X, Shi Q, Zhai Y.Transurethral procedures in the treatment of benign prostatic hyperplasia: a systematic review and meta-analysis of effectiveness and complications[J]. Medicine (Baltimore), 2018, 97(51): 13360-13363.
[9] Hiraoka Y.Transurethral endoscopic enucleation of the prostate (EEP)[J]. World J Urol, 2017, 35(10): 1629-1630
[10] Nnabugwu II, Ugwumba FO, Udeh EI, et al.Learning transurethral resection of the prostate: A comparison of the weight of resected specimen to the weight of enucleated specimen in open prostatectomy[J]. Niger J Clin Pract, 2017, 20(12): 1590-1595.
[11] Chen SS, Lin MJ, Weng MF, et al.Influence of prostate size on the perioperative and postoperative outcome of transurethral plasmakinetic enucleation of theprostate: Results of 892 patients with 3 years of follow-up[J]. J Med Sci, 2018, 34(10): 576-582.
[12] Yu Y, Lou G, Shen C, et al.Technical aspects of transurethral plasmakinetic enucleation and resection of the prostate for benign prostatic hyperplasia[J]. Minim Invasive Ther Allied Technol, 2017, 26(1): 44-50.
[13] Yu Y, Lou G, Shen C, et al.Technical aspects of transurethral plasmakinetic enucleation and resection of the prostate for benign prostatic hyperplasia[J]. Minim Invasive Ther Allied Technol, 2017, 26(1): 44-50.
[14] 袁耀基, 廖剑锋, 梁健, 等. 经尿道双极等离子前列腺剜除术与电切术治疗体积大于60 mL前列腺增生的安全性与有效性的Meta分析[J]. 岭南现代临床外科, 2017, 17(4): 444-451.
[15] Zou Z, Xu A, Zheng S, et al.Dual-centre randomized-controlled trial comparing transurethral endoscopic enucleation of the prostate using diode laser vs bipolar plasmakinetic for the treatment of LUTS secondary of benign prostate obstruction: 1-year follow-up results[J]. World J Urol, 2018, 36(7): 1117-1126.
[16] 蔡季, 王行环, 万少平. 阴茎海绵体神经重建术研究进展[J]. 中华男科学杂志, 2011, 17(7): 644-648.
[17] Rai P, Srivastava A, Singh S, et al.Comparison of bipolar plasmakinetic transurethral enucleation and resection of proatate gland in patients receiving anticoagulants and/or platelet aggregation inhibitors[J]. Minerva Urol Nefrol, 2019, 71(3): 286-293.