关键词:

钬激光前列腺剜除术, 前列腺增生, 改良, 保留尿道黏膜, 尿失禁

Abstract:

Objective To investigate the efficacy and advantage of modified holmium laser enucleation of the prostate（HoLEP）with preservation of partial urethral mucosa in the treatment of benign prostatic hyperplasia （BPH）. Methods 180 patients diagnosed with BPH were enrolled in the study. They were randomly divided into three groups，A，B and C，with 60 patients in each group. Group A received modified HoLEP，group B received conventional HoLEP，and group C received transurethral resection of the prostate（TURP）. Clinical data of preoper⁃ ative，intraoperative and postoperative follow ⁃up were recorded and compared. Results There was no significant difference in the preoperative baseline characteristics among the three groups（P > 0.05）. In terms of operation time and tissue resection efficiency，the modified HoLEP group was superior than the conventional HoLEP group and TURP group（all P < 0.05）. There was no significant difference between the modified HoLEP group and the conventional HoLEP group in bladder irrigation time，indwelling catheter time，the amount of tissue resection and intraoperative blood loss（all P > 0.05），but they were both superior than those of TURP group（P < 0.01）. The incidence of postoperative urinary incontinence in the modified HoLEP group（6.7%）was significantly lower than the conventional HoLEP group（23.3%）（P < 0.05）. Over the follow⁃up period of 6 months，the maximum urinary flow rate，post⁃vociding residual，international prostate symptom score and quality of life score were significantly improved（all P < 0.01）. Conclusion Compared with TURP，conventional HoLEP has low gland residue rate， less intraoperative blood loss and faster postoperative recovery. Modified HoLEP can further improve the enucle⁃ ation efficiency and reduce the incidence of urinary incontinence after operation. Therefore，modified HoLEP is superior for the treatment of BPH and worthy of promotion. 

Key words:

holmium laser enucleation of the prostate, benign prostatic hyperplasia, modified, pres? ervation of partial urethral mucosa, urinary incontinence