Comparison of surgical outcomes between holmium laser enucleation and classical transurethral resection of the prostate in patients with detrusor underactivity

doi:10.3877/cma.j.issn.1674-6899.2017.03.008

Abstract

Abstract:

Objective

To compared the short-term surgical outcomes of holmium laser enucleation of the prostate (HoLEP) and transurethral resection of the prostate (TURP) in patients with detrusor underactivity (DU).

Methods

Retrospectively analysis from Jan. 2010 to May 2015, 352 patients underwent HoLEP or TURP in procedures performed by a single surgeon. Of these patients, 56 patients with both BPH and DU were enrolled in this study (HoLEP, n=24; TURP, n=32). Surgical outcomes were retrospectively compared between the two groups. DU was defined as a detrusor pressure at maximal flow rate of < 40 cmH₂O as measured by a pressure flow study.

Results

The preoperative characteristics of patients and the presence of comorbidities were comparable between the 2 groups.The TURP group showed a significantly shorter operative time than the HoLEP group (P=0.033). The weight of the resected prostate was greater in the HoLEP group, and postoperative voiding parameters, including peak flow rate and postvoid residual urine volume were significantly better in the HoLEP group than in the TURP group.

Conclusions

HoLEP can be effectively and safely performed in patients with DU and can be expected to have better surgical outcomes than TURP in terms of the improvement in lower urinary tract symptoms.

Key words: Prostatic hyperplasia, Transurethral resection of prostate, Holmium lasers

Tao Qiu, Feng Wang, Zhenfeng Shi, Jianjun Zhang, Hesuti Ma, Bin Wen, Ming Li. Comparison of surgical outcomes between holmium laser enucleation and classical transurethral resection of the prostate in patients with detrusor underactivity[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2017, 10(03): 155-159.

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References 22

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组别	例数	年龄(年)	前列腺体积(ml)^a	术前IPSS评分(分)	排尿症状评分(分)	储尿症状评分(分)	最大尿流量(ml / s)	残余尿量(ml)	Pdet Qmax(cmH₂O)
HoLEP组	24	66.9±7.0	58.0±17.8	18.7±6.2	11.1±4.6	7.5±3.4	7.4±3.0	113.0±128.0	34.4±6.5
TURP组	32	71.4±5.6	54.2±13.9	18.7±6.2	9.0±4.8	6.7±3.3	6.3±3.9	151.0±118.0	33.1±10.0
P值	?	0.274	0.386	0.120	0.104	0.348	0.212	0.258	0.575

组别	例数	年龄(年)	前列腺体积(ml)^a	术前IPSS评分(分)	排尿症状评分(分)	储尿症状评分(分)	最大尿流量(ml / s)	残余尿量(ml)	Pdet Qmax(cmH₂O)
HoLEP组	24	66.9±7.0	58.0±17.8	18.7±6.2	11.1±4.6	7.5±3.4	7.4±3.0	113.0±128.0	34.4±6.5
TURP组	32	71.4±5.6	54.2±13.9	18.7±6.2	9.0±4.8	6.7±3.3	6.3±3.9	151.0±118.0	33.1±10.0
P值	?	0.274	0.386	0.120	0.104	0.348	0.212	0.258	0.575

组别	例数	切除体积(g)	手术时间(min)	血红蛋白损失(g/dl)	术后导尿时间(d)	住院时间(d)
HoLEP组	24	39.0 ± 17.7	90.2 ± 15.0	1.2 ± 0.6	3.3 ± 0.6	4.3 ± 0.6
TURP组	32	25.0 ± 7.8	78.8 ± 23.9	1.7 ± 0.9	4.5 ± 1.0	5.5 ± 1.0
P值	?	0.001	0.001	0.001	<0.001	<0.001

组别	例数	切除体积(g)	手术时间(min)	血红蛋白损失(g/dl)	术后导尿时间(d)	住院时间(d)
HoLEP组	24	39.0 ± 17.7	90.2 ± 15.0	1.2 ± 0.6	3.3 ± 0.6	4.3 ± 0.6
TURP组	32	25.0 ± 7.8	78.8 ± 23.9	1.7 ± 0.9	4.5 ± 1.0	5.5 ± 1.0
P值	?	0.001	0.001	0.001	<0.001	<0.001

组别	例数	输血	再次导尿	尿道狭窄	压力性尿失禁
HoLEP组	24	0 (0)	0 (0)	0 (0)	1 (4.2)
TURP组	32	1 (3.1)	1 (3.1)	2 (6.3)	0 (0)
P值	?	0.382	0.382	0.212	0.244

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