比較不同攝護腺鈥雷射剜除手術方式以期降低術後短暫性尿失禁之發生率

林崇裕1、林君軒、吳文正1、李經家1、柯宏龍1、溫聖辰1

高雄醫學大學附設醫院 泌尿部

Comparison of different en bloc HoLEP techniques to reduce the rate of postoperative transient urinary incontinence

Chung-Yu Lin1, Chun-Hsuan Lin1, Wen-Jeng Wu1, Ching-Chia Lee1, Hung-Long Ko1, Sheng-Chen Wen1

Department of Urology1, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

 

Purpose: To investigate postoperative factors in transient urinary incontinence (TUI) after different en bloc holmium laser enucleation of the prostate (HoLEP) techniques and use of 3 horseshoe-shaped incisions.

Materials and Methods: Between January 2017 and October 2019, 169 consecutive patients underwent different HoLEP techniques using original en bloc, en bloc with early mucosal strip detachment, and 3 horseshoe-shaped incisions to treat bladder outlet obstruction. Preoperative variables and surgical quality indexes between groups were recorded. TUI was defined as any hygienic or social problem caused by involuntary loss of urine at 2 weeks postoperatively. Postvoid residual urine (PVR), maximum urinary flow rate (Q max), and International Prostate Symptom Score (IPSS) were assessed

Results: Compared with the original en bloc and en bloc with early mucosal strip detachment techniques, patients in the 3 horseshoe-shaped incision group had a statistically significant decrease in TUI (3.5% vs 9.7% and 14%, respectively; p = 0.001) and IPSS score (p = 0.031). Although not statistically significant, the 3 horseshoe-shaped incisions group showed a trend toward a faster enucleation time (p = 0.051). No life-threatening intraoperative complications were recorded among the 3 groups.

Conclusions: Use of 3 horseshoe-shaped incisions in an en bloc HoLEP technique was shown to prevent urethral sphincter damage with a low rate of postoperative TUI. Further comparative assessment of long-term data in a multicenter trial is required.

    位置
    資料夾名稱
    摘要
    發表人
    TUA秘書處
    單位
    台灣泌尿科醫學會
    建立
    2020-12-24 14:33:09
    最近修訂
    2020-12-24 14:37:09
    瀏覽
    143
    1. 1.
      Podium 01
    2. 2.
      Podium 02
    3. 3.
      Podium 03
    4. 4.
      Moderated Poster 01
    5. 5.
      Moderated Poster 02
    6. 6.
      Moderated Poster 03
    7. 7.
      Non-Discussion Poster