Comparative Study Of Transurethral Resection Of Prostate With And Without Preserving The Urethral Mucosa Of The Apex Of The Prostate

Objective:To compare the clinical efficacy and safety of transurethral resection of prostate(TURP)with and without preserving the urethral mucosa of the apex of the prostate in the treatment of benign prostatic hyperplasia(BPH),and to further explore the significance of preserving prostatic apex urethral mucosa during the operation.Methods:From July 2016 to June 2017,80 patients with benign prostatic hyperplasia(BPH)were retrospectively analyzed.The reasons for treating the patients were mainly the lower urinary tract symptoms such as progressive dysuria,and the conservative treatment was invalid,which were suitable for surgical treatment and excluded the related surgical contraindications.Benign prostatic hyperplasia was confirmed by preoperative examination and postoperative pathology.From July 2016 to December 2016,the 40 patients who were admitted and treated were in group A,and were treated with transurethral resection of the prostate without preserving the urethral mucosa of the apex of the prostate.From January 2017 to June 2017,the patients who were admitted and treated were in group B and were treated with transurethral resection of the prostate(40 cases),which preserved the urethral mucosa of the apex of the prostate.The age,preoperative prostate volume,hemoglobin concentration,international prostate symptom score,quality of life score and maximum urinary flow rate,Time of operation;Intraoperative blood loss;The incidence and recovery of urinary incontinence,transurethral resection of prostate syndrome,perforation of prostate capsule,blood transfusion,secondary hemorrhage,reoperation and urethral stricture.International prostate symptom score,quality of life score,maximum urine flow rate at 1month and 6 months after operation were summed up and compared between group A and group B.Results:All the patients in group A and group B were successfully operated.1.The age,preoperative prostatic volume,hemoglobin concentration,international prostate symptom score,quality of life score and maximum urinary flow rate in group A and B were not statistically significant.2.The operative time of group A was longer than that of group B,and the difference was statistically significant(P<0.05).The volume of intraoperative bleeding in group A was significantly higher than that in group B,and the difference was statistically significant.3.The international prostate symptom score,quality of life and maximal urinary flow rate in group A and B were not statistically significant at 1 month and 6 months after operation.4.In group A,9 cases of urinary incontinence occurred after the removal of urethral catheter,of which 7 cases recovered within 1 week,2 cases recovered within 3 months,and the incidence of urinary incontinence was22.5%.In group B,all patients achieved immediate urinary control after extubation,and the incidence of urinary incontinence was 0.The urinary incontinence in the two groups were compared with X~2=10.141 and P=0.001,and the difference was statistically significant.5.A and B two groups were compared with other complications except for urinary incontinence.The incidence of complications in the two groups were compared with X~2=0.346 and P=0.556,and the difference was not statistically significant.Conclusions:Compare the transurethral resection of the prostate with and without preserving the urethral mucosa of the apex of the prostate,all the patients who adopted preserving the urethral mucosa of the apex of the prostate achieved immediate urinary control after the removal of the urethral catheter,thus avoiding the occurrence of early post-operative stress urinary incontinence.At the same time,this method shortens the operation time,reduces the amount of intraoperative bleeding,and has a good prospect.