| Objective:To compare the the efficacy and safety of benign prostatic hyperplasia(BPH)with diabetes between 1470 nm diode laser enucleation of the prostate(DiLEP)and transurethral plasmakinetic prostatectomy(TUPKP).and provide the reference for the clinical treatment of patients with BPH with diabetes.Methods:BPH patients with diabetes were admitted to study in the urologic depatment of our hospital from October 2015 to January 2018.The main causes of treatment were progressive urinary dysfunction,increased nocturia,and decreased quality of life.The symptoms of lower urinary tract are were main symptoms,and the symptoms are not improved after drug treatment.It is necessary to repeatedly indwell the catheter.Some people refuse to continue oral medication or have complication such as hematuria.According to the operation method is divided into two groups:1470nm diode laser enucleation of the prostate(DiLEP group),a total of 22 cases;Transurethral plasma cut method(TUPKP group),a total of 20 cases.All operations were done by sophisticated surgeons with experience in both group to attenuate deviations of different operators.Contrast of DiLEP and TUPKP group age,preoperative prostate volume by transrectal ultrasound measurement,venous blood prostate specific antigen(PSA),maximum urinary flow rate(Qmax),post void residual(PVR),the international prostate symptom score(IPSS),quality of life score(QOL),venous blood hemoglobin and serum sodium values,preoperative venous blood fasting blood sugar and glycated hemoglobin values,operation time,and postoperative maximum urinary flow rate(Qmax),post void residual(PVR),the international prostate symptom score(IPSS),quality of life score(QOL),venous blood hemoglobin and serum sodium value,catheter indwelling time,bladder douche time and hospital stay.At 3 months after surgery,patients were followed up for the first time in way of follow-up telephone and outpatient review to investigate.Result:In this study,42 cases of patients were successfully completed surgery.No intraoperative open surgery.There were no postoperative surgical hemostasis and blood transfusion again.1.Age,preoperative prostate volume,PSA,IPSS,QOL,Qmax,PVR,hemoglobin and blood sodium index,preoperative venous blood fasting blood glucose and glycosylated hemoglobin in DiLEP and TUPKP groups were not statistically significant(p> 0.05),indicating that the patients selected in the two groups are reasonable and the indicators are comparable.2.The hemoglobin value of the DiLEP group was significantly higher than that of the TUPKP group.The bladder filling time,indwelling catheter time and postoperative hospital stay were significantly shorter in the DiLEP group than in the TUPKP group,and the difference between the two groups in the four indicators.All were statistically significant(p<0.05);there was no significant difference in postoperative venous blood sodium and operative time between the two groups(p>0.05).3.The IPSS,QOL,Qmax and PVR of the DiLEP group and the TUPKP group were significantly improved compared with those before operation,and the difference between the preoperative and postoperative indexes of the same group was statistically significant(p<0.05).).There were no significant differences in the follow-up between the two groups at 3 months after surgery(P>0.05).4.In terms of complications,1 case of urinary incontinence occurred in the DiLEP group,the incidence of complications was 4.5%(1/22);2 cases of postoperative hemorrhage occurred in the TUPKP group,2 cases of urethral stricture,2 cases of urinary incontinence,complications occurred The rate was 20%(6/30),and the difference between the two groups was statistically significant(p<0.05).The difference between the two groups was statistically significant(p<0.05).Conclusion: 1.For BPH patients with diabetes,1470 nm diode laser enucleation of the prostate and transurethral plasmakinetic prostatectomy can significantly improve the symptoms of lower urinary tract,significantly improve the quality of life,and the efficacy is similar.2.1470 nm diode laser enucleation of the prostate compared with transurethral plasmakinetic prostatectomy for benign prostatic hyperplasia with diabetes has no significant difference in operation time,but less intraoperative blood loss,less postoperative complications,rapid postoperative recovery.Tip:DiLEP for the treatment of benign prostatic hyperplasia with diabetes has better safety. |
