Comparative Study Of TURP And SPPC Treatment Methods For Benign Prostatic Hyperplasia

Objective: To compare and evaluate the clinical and cost-effcetiveness of transurethral vaporization of the Prostate(TURP) and suprapubic transveskal prostatectomy (SPPC).Methods: We analyzed the clinical effect of 400 cases that the patients with benign proxtatic hyperplasia (BPH) were treated with TURP or SPPC and compared the operational time, bleeding quantity during the operation, hospitalization time, curative effect and complication of the two groups.The main procedure:1. Case history harvest, pay attention to the characteristics of the hypo-urinary tract, duration and the simultaneous phenomenon. To know the general condition of the patients.2. Physical examination: rectal touch to know the characteristics of the prostate gland.3. To give a mark by I-PSS and QOL preoperatively and 3 months postoperatively.4. Preoperative examination: take PSA in group TURP;all patients take urinary system ultrasonic inspection, uroflometry, and other routine examinations.5. Preoperative preparation:use antibiosis during the operation if the urine routine and the blood routine examination are normal; use antibiosis 3 days postoperatively if the urine routine and the blood routine examination are normal are a little abnormal. 6. Operation methods:Group TURP: use Hawk resectoscope whose cut power is 120 W and electric coagulation power is 60 W. Observe the urethra and bladder.Cut the prostatic tissue from the 6 o'clock point. Cut the lobus medius ,the lobus lateralis sinister and the lobus lateralis dexter until to the capsula prostatica,while the distal end to anterior border of the caput gallinaginis. to stop bleeding thoroughly.Group SPPC:cut into the bladder neck, carry out the decohesion by index finger. Take out of the glandula prostate,and finish the transfixion of the bladder neck. Insert the three-cavity air bag urinary drainage tube through the urinary canal. Suture the incison of the bladder and the skin. Make a stoma at the superior position of the bladder.7. Moniter these indexs during operation:duration ,volume of blooding, volume of blood transfusion,the weight of the cuted prostatic tissue.8. Moniter these indexs postoperatively: the colour of the rinse solution, the speed of the rinse solution, the electrolytes,the washing time and the postoperative complications and so on. Recheck the Qmax,PVR,I-PSS,QOL three months later.9. Follow-up visit: recheck the ur-flow rate, sexual function, long-term complication one year later. 179 cases were followed up in group TURP while 154 cases were followed up in group SPPC.Results: The group of TURP were of shorter operational, hospitalization and indwelling catheter time and less bleeding quantity than the group SPPC. The subjective and objective symptoms of both groups were meliorated greatly.Conclusions: The curative effect of both groups were almost the same, but compared with the other group, patients in the group of TURP were with smaller wound, short recovery time and shorter hospitalization time. TURP can be used as the substitute of SPPC to treat BPH.