Comparison Of Therapeutic Effects And Complications Of Holmium Laser Enucleation And Electroresection Of Prostate With Preservation Of Urinary Structure In The Treatment Of Massive Benign Prostatic Hyperplasia

Research background:Benign prostatic hyperplasia(BPH)is one of the common benign diseases in elderly men,and it is also a common cause of dysuria in elderly men.its incidence increases gradually with the increase of age,and its main clinical manifestation is a lower urinary tract symptom.it mainly includes symptoms such as frequent urination,urgent urination,increased nocturia,urinary weakness and hematuria,and in severe cases,it can also cause bladder stones,hydronephrosis,renal insufficiency and other complications.When most patients see a doctor because of dysuria,the volume of the prostate is often larger..Larger prostate volume increases risk of postoperative urinary incontinence.As more and more patients pay attention to the quality of life after surgery,there are some surgical methods to protect the urine control of patients,in which retaining the urine control of patients in operation will directly affect the quality of life of patients in the future.The purpose of this study is to determine which operation is safe and effective for patients with large volume benign prostatic hyperplasia by studying analysis the comparison of,urine-controlled transurethral holmium laser enucleation of prostate and electroresection in the treatment of large volume prostate.Objective:To compare the efficacy and analysis complications of transurethral holmium laser enucleation of prostate of retaining urine control sturcture with transurethral resection of prostate in patients with large volume prostate.Methods:Collected clinical data of 60 patients with prostate volume>80 ml who underwent transurethral holmium prostate laser enucleation and transurethral prostatectomy performed by the same urologist during October 2018-August 2019 in***Hospital and postoperative follow-up data,the follow-up time was 3 months.The clinical data included age,prostate volume,international prostate symptom score.(IPSS),quality of life score(QOL),postvoid residual utine(PVR),maximum urinary flow rate(Qmax),score of the international erectile function questionnaire(IIFE-5),operation time,amount of resected tissue,loss of hemoglobin,bladder irrigation time,indwelling catheterization time and discharge time.Postoperative follow-up included international prostate symptom score(IPSS),quality of life score(QOL),postvoid residual utine(PVR),maximum urinary flow rate(Qmax),score of international erectile function questionnaire(IIFE-5)and postoperative complications.Transurethral holmium laser enucleation of the prostate with retaining urine control sturcture(HOLEP group)and transurethral resection of the prostate(TURP group)were compared according to the surgical method.Methods SPSS 22.0 was used for data statistics,measurement data were expressed by x ±s,t-test and counting data rate were used for inter-group comparison,and ? 2 test or Fisher exact probability test were used for inter-group comparison.The difference was statistically significant(P<0.05).Results:All the 60 patients with benign prostatic hyperplasia completed the operation successfully.The postoperative IPSS?QOL?Qmax and PVR of the two groups were significantly improved as compared with those before operation(P<0.05),but there was no significant difference in IPSS?QOL?Qmax and PVR between the two groups after operation.The amount of tissue resection,hemoglobin loss,indwelling catheter time,bladder irrigation time and hospital stay in the HOLEP group with retaining urine control sturcture were superior to those in the TURP group(P<0.05).After 3 months of follow-up,the total incidence of operative complications in the HOELP group with retaining urine control sturcture and the TURP group was 10.71%and 43.75%(P=0.011).In terms of the incidence of urinary incontinence,HOELP group with retaining urine control sturcture was 0%and TURP group was 18.75%(P<0.05).Conclusion:Comparing the postoperative indexes between the HOLEP group with retaining urine control sturcture and the TURP group,it was found that the perioperative safety with retaining urine control sturcture HOLEP group was significantly better than the TURP group,and the postoperative complications were lower and the degree of protection of urine control was higher.In HOLEP group which retaining urine control sturcture,enucleation is more complete,hemostasis and bleeding control are better,postoperative recovery is faster,postoperative complications are lower and the degree of urine control protection is higher in patients with large volume prostate.It is worth popularizing as a surgical method to protect urine control in patients with large volume prostate.