Comparison Of Therapeutic Effects And Complications Of Pre-separation Of Urethral Mucosa And Conventional Transurethral Bipolar Plasmakinetic Enucleation Of The Prostate In The Treatment Of Benign Prostatic Hyperplasia

Background:Benign prostatic hyperplasia(BPH)is one of the most common urological diseases in medium-elderly men wordwide,and also the main etiology of their voiding disorders.It’s incidence generally increases with the increase of age.The clinical manifestations of the patients are mainly the following urinary tract symptoms,including frequent urination,increased nocturnal urination,difficulty in holding urine,thinning urinary line,strenuous urination and intermittent urination,etc.If the patients with BPH do not receive standardized diagnosis and treatment,it may lead to acute urinary retention,impaired bladder function and even serious complications such as hydrophrosis and renal insufficiency.With the progress of society and the improvement of people’s living standards,amounting patients begin to emphasize the improvement of postoperative quality of life,among which postoperative urinary incontinence is directly related to patients’ postoperative quality of life.Therefore,different methods have been developed to protect patients’ urinary control function after surgery.In present study,the efficacy and complications of pre-dissection of the urethral mucosa transurethral bipolar plasmakinetic enucleation of the prostate(TUPEP)and conventional TUPEP in the treatment of patients with BPH were explored to determine whether pre-dissection of the urethral mucosa TUPEP is safe and effective in patients with BPH and has better results in postoperative urinary control.Object:To compare the clinical efficacy and complications of pre-dissection of the urethral mucosa TUPEP with conventional TUPEP in the treatment of BPH,so as to evaluate whether this improved operation can reduce the incidence of postoperative complications.Method:A total of 80 patients with BPH who underwent pre-dissection of the urethral mucosa TUPEP or conventional TUPEP,which was performed by the same urologist in the Afiliated Hospital of Yangzhou University from June 2021 to August 2022,were selected as clinical data and postoperative follow-up data.The follow-up time was 3 months.The differences of postoperative efficacy,safety and urinary incontinence between the two groups were compared.Clinical data included age,prostate volume,Maximum urinary flow rate(Qmax),bladder residual urine(PVR),international prostate symptom score(IPSS),and quality of life score(QOL)in both groups.Follow-up data included bladder postvoid residual urine(PVR),maximum urinary flow rate(Qmax),international prostate symptom score(IPSS),quality of life score(QOL),and postoperative complications.According to different surgical methods,pre-dissection of the urethral mucosa TUPEP was called predetached TUPEP group,which was compared with conventional TUPEP as routine TUPEP group.SPSS 25.0 was used for statistical analysis.The measurement data were expressed as x±s,the differences between groups were compared by t-test,the rate of count data was expressed by chi-square test or fisher exact probability test.P<0.05 was considered statistically significant.Results:All patients in both groups completed the surgery successfully and the postoperative pathology was benign prostatic hyperplasia.There was no statistical difference in the preoperative general information between the two groups(P<0.05).The overall postoperative complication rate was lower in the predetached TUPEP group than in the conventional TUPEP group(17.5%vs.37.5%),and the results were statistically different(P<0.05).The incidence of temporary incontinence after catheter removal was significantly lower in the predisconnected TUPEP group than in the conventional TUPEP group(7.5%vs.27.5%),P<0.05.The incidence of moderate or higher incontinence was also lower in the predetached TUPEP group than in the conventional TUPEP group(5.0%vs.20.0%),P<0.05.There was no statistical difference in the improvement of Qmax,PVR,IPSS,and QoL between the conventional TUPEP group and the conventional TUPEP group,but the above indexes were significantly improved in both groups compared with the preoperative ones(P<0.05).Conclusion:Compared with the conventional TUPEP group,the predetached TUPEP group helped to reduce the incidence of postoperative complications in patients,especially the incidence of postoperative temporary urinary incontinence,while ensuring the efficacy and safety of the surgical treatment.