接受單極與雙極經尿道攝護腺刮除術術後發生尿道狹窄與膀胱頸狹窄發生率之比較
劉品均、呂謹亨、童敏哲、許兆畬
台中童綜合醫院 外科部 泌尿科
The incidence of urethral stricture and bladder neck stricture between bipolar and monopolar transurethral resection of prostate
Pin-Chun Liu, Chin-Heng Lu, Min-Che Tung, Chao-Yu Hsu
Division of Urology, Department of Surgery
Tungs’ Taichung MetroHarbor Hospital, Taichung, Taiwan
Purpose: Bipolar transurethral resection of prostate (B-TURP) was introduced as an alternative procedure to minimize the surgical complications of monopolar TURP (M-TURP). However, there are concerns about increased incidence of stricture urethra (SU) after receiving B-TURP. This study was designed to analyze the incidence of stricture urethra and bladder neck stricture among patients undergoing B-TURP versus M-TURP.
Materials and Methods: We retrospectively collected patients who received B-TURP and M-TURP from Jan 1, 2015 to December 31, 2019. We compared the incidence of stricture urethra and bladder neck stricture among two groups. Perioperative outcomes were collected and analyzed. Two groups were compared with t-test and Chi-squared tests were conducted to assess the differences in distributions between the categorical variables. P<0.05 would be considered as significance.
Results: There were a total 227 patients reviewed and analyzed. 131 patients receiving B-TURP and M-TURP with 96 patients. There was no difference between postoperative stricture urethra rate between B-TURP group and M-TURP group (5.3% vs 5.2%, p=1), bladder neck stricture rate (12.9% vs 8.3%, p=0.374). Among post B-TURP SU patients, there was no difference in incidence of DM (p=0.375) and HTN (p=0.702) when compared with non-SU patients. There was no significant difference in baseline characteristics such as age (70.6 vs 70.2, p=0.75), preoperative volume of prostate (49.87 vs 44.89 ml, p=0.17), preoperative PSA level (24.09 vs 40.5 ng/mL, p=0.35). The volume of perioperative blood loss was significantly higher in B-TURP group (76.7 vs 40.47 ml, p=0.0002).
Conclusions: In conclusion, this retrospective study shows the B-TURP is as safe as traditional M-TURP. However, the mean blood loss was lower in patients receiving M-TURP.