A Comparative Study On The Safety And Short-term Efficacy Of Transurethral Resection Of Prostate, Monopolar Transurethral Enucleation Resection Of The Prostate And Holmium Laser Enucleation Of The Prostate For Benign Prostatic Hyperplasia

Research Background:Benign prostatic hyperplasia is one of the most important diseases that cause dysuria in middle-aged and elderly men,surgical intervention is an important way to treat people with severe symptoms.Transurethral resection of prostate(TURP)as the "gold standard" for surgical treatment of benign prostatic hyperplasia has been used in clinical work for many years.However,with the emergence of new technologies and equipment,as well as many limitations of the TURP technique,its status is constantly being impacted.Monopolar transurethral resection of the prostate(mTUERP)achieves a more complete removal of prostate by optimizing the surgical method.Laser technology is now widely used in surgical operations,and the excellent hemostatic effect as well as precise cutting characteristics of holmium laser are even more highly regarded by the industry.So which kind of operation is safer and more recoverable for patients,and what is the difference between the postoperative effects are what we need to study and explore.` Purpose:The purpose of this study was to analyze the safety and short-term efficacy of TURP,mTUERP and holmium laser enucleation of the prostate(HoLEP)in the treatment of benign prostatic hyperplasia.Methods:Retrospective analysis the 159 patients with benign prostatic hyperplasia who underwent surgery at the Second Hospital of Jilin University from December 2017 to July 2019.Among them,53 cases underwent TURP,mTUERP in 65 cases,and 41 cases of HoLEP.We collected the preoperative,intraoperative,and postoperative clinical data,including IPSS score,QOL score,Qmax,hemoglobin decline,serum sodium decline,and indwelling catheter time,Hospitalization time,complications,and IPSS scores,QOL scores,Qmax collected in outpatient or telephone follow-up at 3 and 6 months after surgery,processing statistical analysis.In order to compare the safety and the short-term effect of the three kinds of surgery.Results:Patients who had undergone three surgical methods at 3 and 6 months after surgery had significantly improved IPSS scores,QOL scores,and Qmax compared with those before surgery(P <0.01).The comparison between the three operations was statistically insignificant(P> 0.05);After HoLEP,the hemoglobin decline is the smallest,that is,the amount of bleeding is the smallest,followed by mTUERP;After TURP,the least prostate tissue was removed,and there was no significant difference between patients after HoLEP and mTUERP;After HoLEP,patients had the shortest catheter removal time and hospital stay,followed by patients after mTUERP;HoLEP surgery took the longest time,which was significantly different from the other two surgeries(P <0.01).The comparison of postoperative complications between the three surgical methods was statistically insignificant(P> 0.05).Conclusion:After the treatment of BPH patients by three surgical methods,the postoperative symptoms have been significantly improved,and the effects of the three surgeries were similar;HoLEP is safer and more recoverable for patients,followed by mTUERP.mTUERP can be used as an effective,safer and more recoverable surgical method for clinical work in hospitals without laser equipment.