銩雷射、雙極電刀、單極電刀治療攝護腺肥大之回顧性研究
李淑文 1 、薛又仁 1,2 、黃建榮 1 、蕭毅君 1 、賴昱維 1 、邱文祥 1
1 臺北市立聯合醫院仁愛院區 外科部 泌尿科； 2 國立陽明大學 醫學院 泌尿學科
Thulium laser vaporesection of prostate versus bipolar versus monopolar transurethral resection of prostate in patients with benign prostatic obstruction: a retrospective study
Shu-Wen Li 1 , Thomas Y. Hsueh 1,2 , Andy. C. Huang 1 , Yi-Chun Hsiao 1 , Yu-Wei Lai 1,2
,Allen W. Chiu 1,2
1 Division of Urology, Department of Surgery, Taipei City Hospital renai Branch, Taipei, Taiwan;
2 Department of Urology, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Purpose:
The aim of this study was to evaluate the efficacy and safety of thulium laser vaporesection of prostate(ThuVRP) versus bipolar transurethral resection of prostate(B-TURP) versus monopolar transurethral resection of prostate(M-TURP) in patient with benign prostatic obstruction.
Material and Methods:
Between January 2014 and November 2016, 136 patients underwent transurethral resection of prostate. Among this patients, 25 underwent monopolar transurethral resection of prostate, 29 underwent bipolar transurethral resection of prostate, and 82 underwent thulium laser vaporesection of prostate. Outcome measures included blood loss, catheterization time, and hospital stay. Safety was estimated by urine retention, urinary tract infection, incontinence, bladder neck constriction(BNC), and hematuria.
Results:
No significant differences were noted among the ThuVRP, B-TURP and M-TURP groups, including the age (66.6 vs 67.1 vs 69.16 years old), preoperative prostate volume (57.7 vs 58.8 vs 55.0 g), operative time (74.5 vs 64.4 vs 78.2 minutes) and preoperative hemoglobin level (14.2 vs 13.6 vs 13.8 g/dL). However, there were significant differences in hospital stay (3.7 vs 5.2 vs 4.4 days, p=0.013) and catheterization time (2.97 vs 4.34 vs 3.12 days, p=0.032). The ThuVRP group showed less risk of urinary tract infection than B-TURP or M-TURP groups. Otherwise, there were no differences in urine retention, incontinence, BNC, and hematuria among the three groups.
Conclusion:
This retrospective study indicates that ThuVRP was significantly better for decreasing the incidence of postoperative urinary tract infection and provides shorter hospital stay and catheterization time than B-TURP or M-TURP in the treatment of patients with benign prostatic obstruction. No significant differences were observed in the nature of adverse events such as urine retention, incontinence, BNC, and hematuria among three groups. Therefore, ThuVRP is a safe and efficient way to treat benign prostatic obstruction.