Clinical Study On The Preservation Of Urinary Control Structure In Transurethral Plasma Enucleation Of The Prostate

Objective:To investigate the clinical effect of preserving urine control structure in transurethral plasma enucleation of the prostate(TUERP).Methods:Total number of 160 cases of benign prostatic hyperplasia(BPH)who admitted during June 2014 to September 2016 and met the criteria were included in this study.Group A and group B both included 80 cases registered before and after the end of August 2015,respectively.Summary of surgical methods:group A enucleated the prostate according to the routine method,and did not emphasize the protection of the integrity of the urethral mucosa below the tip of the prostate.In group B,the urethral mucosa below the benign prostatic hyperplasia tissue was carefully preserved,and the integrity of the bladder neck tissue after enucleation of the prostate was preserved as far as possible.The urinary incontinence rates of 1 day,1 week,2 weeks and 1,3 and 6 months after extubation were compared between the two groups.The operative complications were compared between the two groups.The correlation between prostate size,age and postoperative urinary incontinence was analyzed.Results:There were no significant differences in preoperative general condition,operation time,intraoperative blood loss,weight of enucleated glands,continuous irrigation time of bladder and postoperative hospital stay between the two groups(P>0.05).The urinary incontinence rates of group A and group B were 31.25%and 15%,18.75%and 7.5%,16.25%and 6.25%,respectively,on the first day,1 week and 2 weeks after the removal of catheter and there was significant difference between the two groups(P<0.05).The incidence of urinary incontinence in group A and group B was 7.5%and 3.75%,5%and 2.5%,and 1.25%and 0%respectively at 1 month,3 months and 6 months after operation.There was no significant difference between the two groups(P>0.05).Further stratified analysis of prostate volume and age showed that when gland volume was over 80g,the incidence of temporary urinary incontinence in group B was lower than that in group A(15.4%VS 61.1%,P<0.05).For glandular tissue<80g,there was no significant difference in the incidence of temporary urinary incontinence between the two groups(23.4%VS 46.8%,P>0.05).When the age was less than 70 years old,the incidence of temporary urinary incontinence in group B was lower than that in group A(21.7%VS 57.1%,P<0.05).There was no significant difference in the incidence of temporary urinary incontinence between the two groups(23.5%VS 38.7%,P>0.05),when the age was more than 70 years.Conclusions:This study suggests that the urinary incontinence rate in TUERP group is lower than that in TUERP group without urinary control structure after plasma prostatectomy.The urinary control ability of the two groups is similar in the long term after operation,and the operative complications of the two groups are similar.It can be seen that the preservation of urinary control structure is helpful to the rapid recovery of postoperative urinary control function and further improve the quality of life of patients after operation.However,the incidence of temporary urinary incontinence in group A and group B was also correlated with age and prostate volume.When the age was greater than or equal to 70 years old and the weight of prostate was more than or equal to 80 grams,the incidence of temporary urinary incontinence increased significantly after operation.