| Objective: This paper is to evaluate the safety,efficacy and sexual function of transurethral plasma kinetic enucleation of the prostate(PKEP)and transurethral plasma kinetic resection of prostate(PKRP).Methods: From September 2017 to March 2018,80 patients with BPH in the in the china-japan union hospital of jilin university were divided into two groups,among which 40 patients underwent transurethral plasma kinetic enucleation of the prostate as the observation group,and the remaining 40 patients underwent plasma kinetic resection of prostate as the control group.The clinical data,operation time,bleeding volume,complications and the changes of international prostate symptom score,quality of life score and sexual function of the patients were compared and analyzed before and 6 months after operation.Result: The operation time was(46.40±7.63min)vs.(54.96±7.67min),the intraoperative bleeding volume was(20.95±2.26ml)vs.(45.35±4.52ml)and the bladder irrigation time(21.87±2.98 h vs.33.84±4.23h).The indwelling time of urinary catheter(69.54±5.43 h vs.85.00±4.98h),Postoperative bladder irritation sign(3 cases vs.10 cases)and urethral tube extraction and reindwelling(0 cases vs.6 cases)were compared,suggesting statistically significant differences in each indicator(P<0.05).The follow-up index of 6 months after operation: the number of temporary urinary incontinence in observation group was 6 and that in control group was 2.After related treatment,the symptoms of urinary incontinence disappeared.International prostate symptom score(IPSS),maximum urine flow rate(Qmax),post void residual urine volume(PVR)after emptying were significantly improved compared with those before operation,and there was no significant difference between groups(P>0.05).The postoperative erectile function of the patients was compared according to the International Index of erectile function Index(IIEF-5).The results showed that the postoperative score was slightly lower than the preoperative score,but there was no significant difference between the two groups.There was no significant difference between the observation group and the control group in the scores of the two groups after operation.This may be due to the fact that despite the release of prostate obstruction,the position of the cavernous nerve was rich in blood vessels and resected,Hemostasis process may have a certain impact on its function.In the function of ejaculation after operation,The number of patients with postoperative decreased ejaculation in the two groups was more than that before surgery,and the preoperative and postoperative comparison showed statistical difference(P < 0.05),while the number of patients with postoperative decreased ejaculation in the two groups showed no significant difference(P > 0.05).The number of retrograde ejaculation in the postoperative control group was higher than that in the observation group,and the difference was statistically significant(P < 0.05).The frequency of true urinary incontinence was 0 cases of vs.0 cases during the follow-up period of 6 months after operation.There were no secondary bleeding and urethral stricture in both groups.Conclusion:(1)PKEP has the same effect on the short-term effect of the operation as PKRP.(2)PKEP has obvious advantages in operation time,perioperative bleeding volume and incidence of complications.The safety of operation and anesthesia was increased.(3)There was no significant difference in erectile function between the two operations and that before operation.The number of ejaculation decreased in both groups was more than that before operation,and the probability of retrograde ejaculation after PKRP was higher than that after PKEP.To sum up,PKEP is an ideal minimally invasive surgical method and can be used in BPH patients. |
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