Comparative Analysis Of The Efficacy And Safety Of Four Surgical Methods For Transurethral Enucleation Of The Prostate

purpose:Benign prostatic hyperplasia(BPH)is a common disease in middle-aged and elderly people,and the lower urinary tract symptoms caused by this disease seriously affect the quality of life of patients.Transurethral enucleation of the prostate has been widely recognized as an effective surgical method for the treatment of BPH.This study aims to compare the effectiveness and safety of different types of enucleation of the prostate for the treatment of BPH.method:The clinical data of 423 patients who underwent benign prostatic hyperplasia surgery in our hospital from January 2018 to November 2019 were retrospectively analyzed.Among them,124 cases were treated with diode laser enucleation of prostate(Di LEP group),98 cases were treated with holmium laser enucleation of prostate(Ho LEP group),116 cases were treated with plasma kinetic enucleation of prostate(PKEP group).And the other 54 cases were treated with thulium: YAG laser vapoenucleation of prostate(THu VEP group).The operation time,postoperative hemoglobin decline value,bladder irrigation time,Qmax,IPSS score,QOL score,and postoperative bleeding,urinary tract infection,urethral stricture,dysuria,urinary incontinence and other complications were compared among the four groups,to analyze the efficacy and safety of these surgical methods.result:All operations were successful.There was no significant difference in age and prostate volume between the four groups(P> 0.05).Postoperative Qmax,IPSS score,QOL score and other efficacy indicators were significantly improved compared with before surgery(P<0.05),and there was no significant difference between groups by statistical analysis(P>0.05).The perioperative data of the four groups were significantly different after comparison(P <0.05),and further comparisons between the groups revealed that: the operation time of the THu VEP group was longer than that of the other three groups;In terms of hemostasis during the operation,Di LEP and THu VEP had the best effects.Ho LEP was behind them.PKEP had worse hemostasis than the three lasers described above;in terms of bladder irrigation time,PKEP had a longer postoperative irrigation time than the other three groups.In terms of postoperative complications: there was no significant difference in the incidence of postoperative bleeding,urinary tract infection,urethral stricture,and dysuria in the four groups(P> 0.05).The incidence of urinary incontinence in the PKEP group was higher than in the Di LEP group.conclusion:Transurethral enucleation of the prostate with four energy platforms for BPH performed well in alleviating lower urinary tract symptoms.Although THu VEP has low vaporization cutting efficiency,it has obvious curative effect and high safety,and Di LEP has good comprehensive performance.Both of them are worthy of clinical promotion.