Abstract:

Objective To explore and compare the efficacy and safety of different transurethral enucleation procedures for treating benign prostatic hyperplasia. Methods A retrospective analysis was conducted on the clinical data of 215 patients with benign prostatic hyperplasia admitted to our hospital from January 2021 to May 2023. According to the surgical procedures， they were divided into plasma resection group （n = 81）， treated with transurethral plasma resection of the prostate， laser resection group （n = 92）， treated with transurethral laser resection of the prostate， and green laser enucleation group （n = 42）， treated with transurethral green laser enucleation of the prostate. The three groups were compared in terms of perioperative indicators （surgical time， intraoperative bleeding volume， bladder flushing time， indwelling catheter time， postoperative hemoglobin concentration， and hospital stay）， urodynamic indicators （RUV， IPSS score， Qmax， and QOL score）， and postoperative complications. Results The green laser enucleation group and laser resection group demonstrated a significantly higher total effective rate compared to the plasma electrosurgery group （P < 0.05）. The three groups showed no statistically significant difference in hospital stay （P > 0.05）， but the green laser enucleation group showed a significantly shorter surgical time compared to the other two group （P < 0.05）. The green laser enucleation group and laser resection group had superiority in intraoperative bleeding， bladder flushing time， and indwelling catheter time compared to the plasma resection group， and a significantly higher postoperative hemoglobin concentration compared to the plasma resection group （P < 0.05）. Repeated measurement analysis of variance showed that the three groups all exhibited significantly decreases in RUV， IPSS score， and QOL score （P < 0.05）， and a significantly increase in Qmax at 1 month and 3 months after surgery （P < 0.05）. The laser resection group and green laser enucleation group presented with significant decreases in RUV， IPSS score， and QOL score （P < 0.05）， and a significantly decrease in Qmax compared to the plasma resection group at 1 month and 3 months after surgery （P < 0.05）. However， the laser resection group and the green laser enucleation group had no statistically significant difference in RUV， IPSS score， Qmax， and QOL score at 1 month and 3 months after surgery （P > 0.05）. The green laser enucleation group had the lowest total incidence of postoperative complications， following by the laser resection group and plasma resection group in order （7.14% vs. 21.74% vs. 35.80%， P < 0.05）. Conclusion The three surgical procedures all have good therapeutic effects on benign prostatic hyperplasia. Transurethral laser prostatectomy and green laser enucleation have superiority to those of transurethral plasma resection of the prostate in efficacy and safety， and they can promote early recovery of patients. Transurethral green laser enucleation is the best in safety.

Key words: benign prostatic hyperplasia, transurethral, plasma electrocautery, laser resection, green laser enucleation