Safety and long-term follow-up analysis of HoLEP and BPRP in the treatment of large volume benign prostatic hyperplasia
10.3760/cma.j.cn115396-20240710-00215
- VernacularTitle:HoLEP与BPRP治疗大体积良性前列腺增生的安全性及长期随访分析
- Author:
Tong ZHOU
1
;
Hongqiao WANG
Author Information
1. 河北省沧州中西医结合医院普外科，沧州 061000
- Keywords:
Holmium laser enucleation of the prostate;
Bipolar plasma resection of the prostate;
Prostatic hyperplasia;
Safety;
Quality of life;
Postoperative complica
- From:
International Journal of Surgery
2025;52(6):391-397
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the safety of Holmium laser enucleation of the prostate (HoLEP) and bipolar plasma resection of prostate (BPRP) in the treatment of large volume benign prostatic hyperplasia (LV-BPH), and to analyze their long-term follow-up results.Methods:Two hundred patients of LV-BPH admitted to Cangzhou Hospital of Integrated TCM-WM·Hebei from January 2022 to January 2024 were retrospectively selected and divided into BPRP group and HoLEP group according to different treatment methods, with 100 cases in each group. Patients in BPRP group were treated with BPRP, and patients in HoLEP group were treated with HoLEP. The clinical data, perioperative indicators, postoperative complications and long-term follow-up results were compared between groups. Measurement data were expressed as mean±standard deviation ( ± s), paired sample t-test was used for intra-group comparison, covariance analysis or independent sample t-test was used for inter-group comparison, and analysis of variance of repeated measurement data was used for multi-time node comparison. Count data were expressed as the cases and percentage, and Chi-square test was used for comparison between groups. Results:The operation time [(31.46±13.47) min vs (40.25±15.33) min], clearance time [(28.14±12.94) min vs (37.16±13.15) min] and the decrease in hemoglobin [(5.14±1.93) g/L vs (7.92±2.45) g/L] of patients in the HoLEP group were lower than those in the BPRP group, and the clearance efficiency [(1.58±0.19) g/min vs (1.30±0.10) g/min] was higher than that in the BPRP group, and the differences were statistically significant ( P<0.05). The incidence of postoperative hematuria (1.00% vs 8.00%) in HoLEP group was lower than that in BPRP group, and the difference was statistically significant ( P<0.05). There were no statistically significant differences in the incidence of other complications and total complications except hematuria between BPRP group and HoLEP group ( P>0.05). The results of covariance analysis showed that there were no statistically significant differences in serum sodium, prostate specific antigen (PSA) levels, maximum urine flow rate (Qmax), postvoid residual urine (PVR), international prostate symptom score (IPSS) and quality of life (QOL) score at different time points after the operation ( P>0.05). The analysis of variance of repeated measurement data showed that the group effects of the above indexes were F=0.91, 0.52, 1.30, 0.40, 0.02, 0.63, respectively, all P>0.05, and the time effects were F=18.57, 104.31, 814.68, 1 106.64, 1 894.37, 555.31, respectively, all P<0.001, and the interaction effects were F=2.79, 0.75, 1.22, 1.20, 0.02, 0.72, respectively, all P>0.05. Conclusions:The application of HoLEP and BPRP in LV-BPH patients are beneficial to improve prostate symptoms and quality of life, with equal safety and effectiveness. However, compared with BPRP, HoLEP applied to LV-BPH patients has the advantages of short operation time, high clearance efficiency, small decrease of hemoglobin and low risk of postoperative hematuria.
