Study On The Clinical Application Of Modified Holmium Laser Enucleation Of The Prostate

Objective: To evaluate the safety and efficacy of modified holmium laser enucleation of the prostate(HoLEP)on treatment of benign prostatic hyperplasia(BPH).Method:Retrospectively analyze 115 cases of patients with BPH received Ho LEP in Urologic Surgery Department of our hospital from January of 2015 to June of 2016 in which 60 cases of patients received traditional HoLEP and 55 cases of patients were conducted modified HoLEP.Age,prostate volume,resectionof prostate tissue weight,operation time(including enucleation time and morcellation time),morcellation efficiency,preoperativeand postoperative hemoglobin andserum sodium,bladder irrigation time,catheterization time,postoperative hospital stay,preoperative and postoperative 1,3,6 months of international prostate symptom score(IPSS),quality of life score(QoL),maximum urinary flow rate(Qmax),postvoid residual volume(PVR)and complications of patients in the two groups have been recorded and conducted statistic analysis.Result:1.There was no significant difference between the two groups preoperative general information(P > 0.05).2.The time of operation(including enucleation time and morcellation time)was shorter and the morcellation efficiency was higher in the modified HoLEP group compared with those of the traditional HoLEP group,the differences were statistically significant(P <0.05).However,the change value of hemoglobin and serum sodium(preoperative and postoperative),bladder irrigation time,catheterization time and postoperative hospital stays were not statistically different(P>0.05).No blood transfusion,transurethral resection syndrome and death happened in both two groups.There were 3 cases of bladder injury in the traditional HoLEP group and 0 case in the modified HoLEP group.The differences were no statistically significant(P > 0.05).3.Postoperative 1,3,6 months of IPSS,QoL,Qmaxand PVR were all improved compared with those preoperative values,the differences were statistically significant(P < 0.05),and there were no significant differences between the two groups(P > 0.05).4.The incidence of urinary incontinence in the modified HoLEP group was lower than those of traditional HoLEP group at 2 weeks and 1month after operation,the differences were statistically significant(P <0.05),and there were no significant differences in the incidence of urinaryincontinence at 3 and 6 months after operation between the two groups(P > 0.05).There were no significant differences in the postoperative urinary retention,secondary hemorrhage,urethral stricture and bladder neck contracture between the two groups(P > 0.05).Conclusion:1.The modified HoLEP is safe and reliable with short operation time and high morcellation efficiency.2.The modified HoLEP has the same clinical efficacy as the traditional HoLEP.3.The modified Ho LEP can reduce the incidence of early urinary incontinence than the traditional HoLEP.