Transurethral diode laser enucleation versus transurethral electrovaporization resection of the prostate for benign prostatic hyperplasia with different prostate volumes.
- Author:
Duo LIU
1
;
Li FAN
1
;
Cheng LIU
1
;
Xue-Jun LIU
1
;
Dong-Sheng ZHU
1
;
Jia-Gui MU
1
;
Dong-Wei YAO
1
;
Qun SONG
1
Author Information
1. Department of Urology, The Second People's Hospital of Lianyungang, Lianyungang, Jiangsu 222000, China.
- Publication Type:Journal Article
- Keywords:
benign prostate hyperplasia;
diode laser enucleation of the prostate;
transurethral resection of the prostate
- MeSH:
Humans;
Lasers, Semiconductor;
adverse effects;
therapeutic use;
Male;
Operative Time;
Organ Size;
Postoperative Complications;
etiology;
Prostate;
pathology;
Prostatic Hyperplasia;
pathology;
surgery;
Quality of Life;
Retrospective Studies;
Therapeutic Irrigation;
Transurethral Resection of Prostate;
adverse effects;
methods;
statistics & numerical data;
Treatment Outcome;
Urethral Stricture;
etiology;
Urinary Catheterization;
Urinary Incontinence;
etiology
- From:
National Journal of Andrology
2017;23(3):217-222
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical effect of diode laser enucleation of the prostate (DIOD) with that of transurethral resection of the prostate (TURP) on benign prostate hyperplasia (BPH) with different prostate volumes.
METHODS:This retrospective study included 256 BPH patients treated by DIOD (n = 141) or TURP (n = 115) from March 2012 to August 2015. According to the prostate volume, we divided the patients into three groups: <60 ml (42 for DIOD and 31 for TURP), 60－80 ml (51 for DIOD and 45 for TURP), and >80 ml (48 for DIOD and 39 for TURP). We obtained the relevant data from the patients before, during and at 6 months after surgery, and compared the two surgical strategies in operation time, perioperative levels of hemoglobin and sodium ion, post-operative urethral catheterization time and bladder irrigation time, pre- and post-operative serum PSA levels, International Prostate Symptoms Score (IPSS), post-void residual urine (PVR) volume and maximum urinary flow rate (Qmax), and incidence of post-operative complications among different groups.
RESULTS:In the <60 ml group, there were no remarkable differences in the peri- and post-operative parameters between the two surgical strategies. In the 60－80 ml group, DIOD exhibited a significant superiority over TURP in the perioperative levels of hemoglobin (［3.25 ± 1.53］ g/L vs ［4.77 ± 1.67］ g/L, P <0.05) and Na+ (［3.58 ± 1.27］mmol/L vs ［9.67 ± 2.67］ mmol/L, P <0.01), bladder irrigation time (［30.06 ± 6.22］h vs ［58.32 ± 10.25］ h, P <0.01), and urethral catheterization time (［47.61 ± 13.55］ h vs ［68.01 ± 9.69］ h, P <0.01), but a more significant decline than the latter in the postoperative PSA level (［2.34 ± 1.29］ ng/ml vs ［1.09 ± 0.72］ ng/ml, P <0.05), and similar decline was also seen in the >80 ml group (［3.35 ± 1.39］ ng/ml vs ［1.76 ± 0.91］ ng/ml, P <0.05). No blood transfusion was necessitated and nor postoperative transurethral resection syndrome or urethral stricture observed in DIOD. However, the incidence rate of postoperative pseudo-urinary incontinence was significantly higher in the DIOD (22.7%, 32/141) than in the TURP group (7.83%, 9/115) (P <0.05).
CONCLUSIONS:DIOD, with its obvious advantages of less blood loss, higher safety, faster recovery, and more definite short-term effectiveness, is better than TURP in the treatment of BPH with medium or large prostate volume and similar to the latter with small prostate volume.
