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目的探讨经尿道双极等离子电切术(TKRP)治疗良性前列腺增生(BPH)的疗效及其对性功能的影响。方法选取2009年1月至2011年6月于复旦大学附属中山医院青浦分院就诊的BPH患者130例,按照手术方式不同分为TKRP组和经尿道前列腺电切术(TURP)组,两组各65例。观察两组的国际前列腺症状评分(IPSS)、生活质量评分(QOL)和最大尿流率(Qmax),手术时间,切除前列腺组织的重量,术中出血量,留置尿管时间,术后住院时间,阴茎勃起功能障碍(ED)和逆行射精(RE)发生率。结果 TKRP组的术中出血量,置管时间和术后住院时间较TURP组明显降低(P<0.01),而手术时间和切除组织两组差异无统计学意义(P>0.05)。两组术后IPSS、QOL和残余尿水平较术前明显降低,两组的Qmax术后较术前明显提高(P<0.01);两组治疗后比较,差异无统计学意义(P>0.05)。TKRP组的6个月和9个月的ED发生率低于TURP组(P<0.05),而两组的RE发生率差异无统计学意义(P>0.05)。结论 TKRP治疗BPH具有创伤小,恢复快,对性功能影响小等优点,是一种理想的微创手术。
Objective To investigate the efficacy of transurethral bipolar plasmakinetic excision (TKRP) in the treatment of benign prostatic hyperplasia (BPH) and its effect on sexual function. Methods A total of 130 BPH patients were treated in Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University from January 2009 to June 2011. The patients were divided into TKRP group and TURP group according to the operation method. example. The IPSS, QOL and Qmax of the two groups were observed. The operation time, the weight of the resected prostate tissue, the amount of blood loss during operation, the duration of indwelling catheter, the postoperative hospital stay , Erectile dysfunction (ED) and retrograde ejaculation (RE). Results The amount of bleeding, catheterization and postoperative hospital stay in TKRP group were significantly lower than those in TURP group (P <0.01). There was no significant difference in operative time and resection between the two groups (P> 0.05). The postoperative IPSS, QOL and residual urine levels in both groups were significantly lower than those before operation, Qmax in both groups were significantly higher than those before operation (P <0.01), but there was no significant difference between the two groups after treatment (P> 0.05) . The incidence of ED at 6 months and 9 months in TKRP group was lower than that in TURP group (P <0.05). There was no significant difference in the incidence of RE between the two groups (P> 0.05). Conclusion TKRP is an ideal minimally invasive surgery for the treatment of BPH with less trauma, faster recovery and less impact on sexual function.