Observation On The Efficacy Of Transurethral Green Laser Enucleation Of The Prostate And Transurethral Resection Of Prostate In The Treatment Of Benign Prostatic Hyperplasia

Purpose:To compare the application value of transurethral green laser enucleation of the prostate(GreenLEP)and transurethral resection of the prostate(TURP)in elderly patients with benign prostatic hyperplasia(BPH).Methods:A retrospective analysis was conducted on patients who underwent GreenLEP or TURP surgery at the First Affiliated Hospital of Soochow University from January 2020 to January 2023.The surgeries were performed by the same skilled surgeon and perioperative clinical data were collected,including age,prostate volume(PV)and three diameters,tPSA,fPSA,hemoglobin,sodium,postvoid residual volume(PVR),maximum urine flow rate(Qmax),International Prostate Symptom Score(IPSS),Quality of Life score(QoL),surgical time,bladder irrigation time,and prostate resection weight.The patients were divided into three subgroups based on prostate volume(Group Ⅰ:<60ml,Group Ⅱ:60-80ml,Group Ⅲ:>80ml).The complications,including capsule perforation,transurethral resection syndrome(TURS),urinary retention,urinary incontinence,urethral stricture,bladder neck spasm,retrograde ejaculation,and rebleeding were recorded and compared between the two groups and within each subgroup.Results:A total of 195 cases of BPH were included,with 107 cases in the GreenLEP group and 88 cases in the TURP group.There was no significant statistical difference in the baseline characteristics between the two groups.Both surgical methods were successfully completed,and no cases were converted to open surgery.Compared with the TURP group,the GreenLEP group had a statistically significant difference(P<0.05)in terms of prostate resection weight,bladder irrigation time,hemoglobin and sodium changes,Qmax increase,IPSS and QoL score reduce.However,surgical time showed no significant difference(P=0.118).Among the three subgroups.Group I had significant differences(P<0.05)in surgical time,prostate resection weight.QoL score reduce,bladder irrigation time,hemoglobin and sodium changes,but Qmax increase(P=0.086)and IPSS reduce(P=0.994)were not statistically significant.In Group Ⅱ andⅢ.there were significant differences(P<0.05)in surgical time,prostate resection weight.Qmax increase.IPSS reduce,and QoL score reduce.The complication rate was relatively lower in the GreenLEP group than in the TURP group(Group Ⅱ:P=0.025),Conclusion:Both GreenLEP and TURP have significant benefits for patients with BPH.Compared with TURP.GreenLEP can remove more hyperplastic tissue,with less bleeding and lower complication rates.Subgroup analysis shows that for patients with smaller prostate volumes,GreenLEP surgery has no significant advantage over TURP in terms of operation time,while for patients with larger prostate volumes(GroupⅢ:>80ml),GreenLEP has a significantly lower operation time than TURP and has an advantage,while for patients with the prostate volumes(Group Ⅱ:60-80ml).the GreenLEP group had an advantage in postoperative complication rates,and the improvement in maximum urine flow rate and quality of life after surgery is more significant with GreenLEP compared to TURP.