Photoselective enucleation of prostate versus tranuretheral resection of the prostate for large-size benign prostatic hyperplasia: a randomized prospective controlled study

Dishi YAN; Zhengchao LIU; Jun ZHENG; Tao JIANG; Zhipeng CHEN; Yongquan WANG; Xiaozhou ZHOU; Yuanxiu ZHOU; Zhansong ZHOU; Wenhao SHEN

doi:10.16016/j.1000-5404.202009030

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Photoselective enucleation of prostate versus tranuretheral resection of the prostate for large-size benign prostatic hyperplasia: a randomized prospective controlled study

Clinical Medicine | 更新时间：2026-01-09

- Photoselective enucleation of prostate versus tranuretheral resection of the prostate for large-size benign prostatic hyperplasia: a randomized prospective controlled study
- Journal of Third Military Medical University Vol. 43, Issue 3, Pages: 255-260(2021)
- 作者机构：
  
  400038 重庆，陆军军医大学(第三军医大学)第一附属医院全军泌尿外科研究所
- 作者简介：
- 基金信息：
  
  the General Project of Technology Innovation and Application Demonstration of Chongqing (Social and People's Livelihood(CSTC2018jscx-mxybx0190);the Project of Technology Innovation Plan in Major Fields of the First Affiliated Hospital of Army Medical University(SWH2016ZDCX2008)
- DOI：10.16016/j.1000-5404.202009030
  CLC： R181.32;R697.32;R699.8
- Received：05 September 2020，
  
  Revised：2020-10-29，
  
  Published：15 February 2021
- 稿件说明：
移动端阅览
Dishi YAN, Zhengchao LIU, Jun ZHENG, et al. Photoselective enucleation of prostate versus tranuretheral resection of the prostate for large-size benign prostatic hyperplasia: a randomized prospective controlled study[J]. Journal of Third Military Medical University, 2021, 43(3): 255-260.
DOI：

Dishi YAN, Zhengchao LIU, Jun ZHENG, et al. Photoselective enucleation of prostate versus tranuretheral resection of the prostate for large-size benign prostatic hyperplasia: a randomized prospective controlled study[J]. Journal of Third Military Medical University, 2021, 43(3): 255-260. DOI： 10.16016/j.1000-5404.202009030.

摘要

目的

对比研究经尿道绿激光直出光纤前列腺锐性剜除术(photoselective sharp-enucleation of prostate with end-firing fibre，PSEP)与经尿道前列腺电切术(transurethral resection of prostate

TURP)治疗大体积良性前列腺增生症(benign prostatic hyperplasia，BPH)患者的安全性和有效性。

方法

根据本研究的纳入和排除标准，选取2018年7月至2019年12月在本院诊治并且前列腺体积(prostate volume，PV)＞80 mL的BPH患者，采用随机数字表法分成两组，每组47例，分别行TURP(TURP组)和PSEP(PSEP组)，收集两组患者的一般情况和围手术期资料，记录并比较术后1、6个月的最大尿流率(maximum urine flow rate，Qmax)、国际前列腺症状评分(international prostate symptom score，IPSS)、残余尿(post-void residual urine，PVR)、生活质量评分(quality of life score，Qols)、国际尿失禁咨询委员会尿失禁问卷表简表(international consultation on incontinence questionnaire-urinary incontinence-short form，ICI-Q-SF评分)、前列腺特异抗原(prostate-specific antigen，PSA)、PV以及相关并发症等。

结果

术后6个月，PSEP组和TURP组分别有43例和44例完成随访。两组术前一般情况差异无统计学意义，术后1、6个月两组Qmax、IPSS、Qols、PVR、PSA及ICI-Q-SF评分较术前均有明显改善。PSEP组比TURP组有更短的手术时间、膀胱冲洗时间、留置尿管时间、住院时间和更少的血红蛋白下降量。术后6个月PSEP组PV明显小于TURP组。两组术后并发症发生率差异无统计学意义。

结论

PSEP与TURP治疗大体积BPH疗效肯定，具有良好的安全性。与TURP相比，PSEP具有手术效率高、出血量少、组织去除更彻底、术后恢复快的优点，是治疗大体积BPH患者的更优选择。

Abstract

Objective

To compare the efficacy and safety of photoselective sharp-enucleation of prostate with end-firing fibre (PSEP) and tranuretheral resection of the prostate (TURP) in the treatment of large-size benign prostatic hyperplasia (BPH).

Methods

According to the inclusion and exclusion criteria of the study

totally 94 BPH patients with prostate volume (PV) >80 mL admitted in our hospital from July 2018 to December 2019 were prospectively enrolled

and then randomized into TURP and PSEP group

with 47 cases in each group. Preoperative and perioperative data were collected

and maximum flow rate (Qmax)

international prostate symptom score (IPSS)

post-void residual urine (PVR)

quality of life score (Qols)

score of international consultation on incontinence questionnaire-urinary incontinence-short form (ICI-Q-SF)

prostate-specific antigen (PSA) level

PV and related complications in 1 and 6 months after surgery were recorded and compared between the 2 groups.

Results

There were 43 and 44 patients completing the followed-up in PSEP and TURP groups respectively in 6 month postoperatively. No significant differences were found in baseline data between the 2 groups

and Qmax

PVR

PSA level

and scores of IPSS

Qols and ICI-Q-SF were significantly improved at 1 and 6 months after surgery in both groups. The operation time (71.6±21.2

87.6±18.9 min

0.01)

bladder irrigation time (7.1±5.7

19.8 ±8.6 h

0.01)

catheterization period (3.4±1.7

4.4±1.6 d

0.01)

and length of hospital stay (4.3±1.0

5.2±1.3 d

0.01) were significantly shorter in the PSEP group than those in the TURP group. The former group also had remarkably milder haemoglobin dropping (5.5±3.2

12.2±6.6 g/L

0.01)

and more obviously smal

ler PV (21.3±4.0

25.2±6.1 mL

0.01) in 6 months when compared with the latter group. What's more

there was no statistical difference in the incidence of postoperative complications between them.

Conclusion

Both PSEP and TURP show good efficacy and safety in the treatment of large-size BPH. Compared with TURP

PSEP has the advantages of high surgical efficiency

less bleeding

more thorough tissue removal

and faster postoperative recovery. It is an optional choice for the patients with large-size BPH.

关键词

Keywords

references

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