经尿道前列腺切除术的疗效和安全性

S. Bhat, M. Bhat, Adil Ahmad, M. Ahmed, Syed Javaid Qadri
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摘要

背景:良性前列腺增生(BPH)是老年男性最常见的泌尿系统疾病之一。建议对药物治疗无反应或出现BPH相关并发症的患者进行手术治疗。去核术是大型前列腺增生患者的一种成功治疗选择,它模仿了开放式前列腺摘除术,与开放式技术相比,具有良好的手术效率、减少并发症、更快的术后恢复、相似的前列腺组织消融能力和令人满意的随访结果。目的:评价经尿道前列腺摘除术的安全性和有效性。方法:45岁以上有BPH引起膀胱出口梗阻症状、最大尿流量(Qmax)<15ml/s的患者,药物未能缓解症状或急性尿潴留至少一项无导管试验失败或前列腺增生引起的复发性肉眼血尿或前列腺增生导致的膀胱出口梗阻引起的上尿路改变,以及愿意接受经尿道前列腺切除术(TUEP)的患者均被纳入本研究。结果:在我们的研究中,年龄在55-90岁之间的患者被纳入。最常见的主诉是尿频和急性尿潴留。术前平均前列腺大小为102.9±10.90g,范围为84-126g。平均手术时间为86.71±5.24分钟。平均术后ID导管为2.1±1.63天。术后尿流量测定和国际前列腺症状评分(IPSS)显著改善。结论:TUEP是一种很有前途的内镜下治疗大型良性前列腺肥大(BPE)的方法,它模仿了传统的前列腺摘除术,同时具有微创手术的所有优点。
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Efficacy and Safety of Transurethral Enucleation of Prostate
Background: Benign Prostatic Hyperplasia (BPH) is one of the most common urological diseases seen in aging men. Surgical treatment is recommended for patients unresponsive to medical therapy or those who have developed BPH-related complications. Enucleation procedure distinguished itself as a successful treatment option in large BPH patients, mimics open prostate enucleation, characterized by good surgical efficiency, reduced complications, faster postoperative recovery, similar prostatic tissue ablation capabilities and satisfactory follow-up results compared with the open technique. Objectives: To assess the safety and efficacy of transurethral enucleation of prostate. Methods: Patients aged above 45 years with symptoms of bladder outlet obstruction due to BPH, with maximal urinary flow rate (Qmax) of <15 ml/s, failure to relieve symptoms by medications or acute urinary retention failing at least one trial without catheter or recurrent gross hematuria due to prostatomegaly or upper urinary tract changes due to bladder outlet obstruction due to BPH and patient willing to undergo Transurethral Resection of the Prostate (TUEP) were included in this study. Results: In our study patients aged between 55-90 years were enrolled. Most common presenting complaints were frequency and acute urinary retention. Mean preoperative prostate size was 102.9 ± 10.90g with a range of 84-126 g. Mean operative time was 86.71 ± 5.24 minutes. The mean postoperative ID catheter was 2.1+1.63 days. Postoperative uroflowmetry and International Prostate Symptom Score (IPSS) improved significantly. Conclusion: TUEP represents a promising endoscopic approach in large Benign Prostate Enlargement (BPE) cases, mimics conventional open method of enucleation of the prostate while having all the advantages of a minimally invasive surgery.
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