不同手术方法治疗大体积前列腺增生术后尿失禁、性功能变化的对比研究
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摘要
目的对比分析不同手术方法治疗大体积前列腺增生术后尿失禁、性功能变化。方法选取2015年1月至2017年1月鄂东医疗集团黄石市中心医院(湖北理工学院附属医院)诊治的94例大体积前列腺增生患者作为研究对象。按照随机表法分为A组和B组,每组47例。A组采用经尿道前列腺等离子切除术,B组采用经尿道前列腺电切术治疗。比较两组手术时间、术后留置导尿管时间及住院时间,术前和术后6个月IPSS评分、残余尿量、Qmax和QOL评分变化,术后尿失禁发生和术后术后6个月性功能障碍发生情况。结果 A组手术时间、术后留置导尿管时间及住院时间均短于B组,差异具有统计学意义(P<0.05)。两组术后6个月IPSS评分、残余尿量和QOL评分降低而Qmax增加(观察组:t=39.3588、104.5085、37.9827、8.8270,对照组:t=26.4814、84.0084、32.4105、6.1279),差异具有统计学意义(P<0.05);A组术后6个月IPSS评分、残余尿量和QOL评分低于B组而Qmax高于B组(t=6.1208、10.2366、8.9515、7.0501,P<0.05)。A组术后尿失禁发生率(2.13%)低于B组(19.15%),差异具有统计学意义(P<0.05)。A组术后6个月性功能障碍发生率(10.64%)低于B组(33.40%),差异具有统计学意义(P<0.05)。结论大体积前列腺增生患者采用经尿道前列腺等离子切除术相比于经尿道前列腺电切术治疗术后尿失禁发生少,且性功能障碍少,具有重要研究价值。
Objective To compare and analyze the changes in urinary incontinence and sexual function of patients with massive prostatic hyperplasia after different kinds of operation. Methods 94 patients with massive prostatic hyperplasia in our hospital from January 2015 to January 2017 were selected.According to the random table method, they were divided into group A and group B, with 47 cases in each group. Group A received transurethralplasma resection of prostate, and group B received transurethral resection of prostate. The catheter indwelling time, hospital stay and operation time were compared between the two groups.Changes in IPSS score, residual urine volume, Qmax score and QOL score between before and 6 months after surgery, the incidence of postoperative urinary incontinence and sexual dysfunction at 6 months after surgery were compared. Results The operation time, the indwelling catheter time and the length of hospital stay in group A were shorter than these in group B(P<0.05). IPSS score, residual urine volume and QOL scoreat 6 monthsafter surgery decreased in the two groups and Qmax increased(group A:t=39.3588, 104.5085, 37.9827, 8.8270, group B:t=26.4814, 84.0084, 32.4105, 6.1279, P<0.05). At 6 months after surgery, IPSS score, residual urine volume and QOL score in group A were lower than these in group B and Qmaxin group A was higher than that of group B(t=6.1208, 10.2366, 8.9515, 7.0501, P<0.05). The incidence of urinary incontinence after operation in group A(2.13%) was lower than that in group B(19.15%)(P<0.05). The incidence of sexual dysfunction at 6 months after operation in group A(10.64%) was lower than that in group B(33.40%)(P<0.05). Conclusions Compared with transurethral resection of prostate, transurethral plasma resection of prostate for patients with large volume benign prostatic hyperplasia is of low incidence of postoperative urinary incontinence and sexual dysfunction, which has important research value.
Objective To compare and analyze the changes in urinary incontinence and sexual function of patients with massive prostatic hyperplasia after different kinds of operation. Methods 94 patients with massive prostatic hyperplasia in our hospital from January 2015 to January 2017 were selected.According to the random table method, they were divided into group A and group B, with 47 cases in each group. Group A received transurethralplasma resection of prostate, and group B received transurethral resection of prostate. The catheter indwelling time, hospital stay and operation time were compared between the two groups.Changes in IPSS score, residual urine volume, Qmax score and QOL score between before and 6 months after surgery, the incidence of postoperative urinary incontinence and sexual dysfunction at 6 months after surgery were compared. Results The operation time, the indwelling catheter time and the length of hospital stay in group A were shorter than these in group B(P<0.05). IPSS score, residual urine volume and QOL scoreat 6 monthsafter surgery decreased in the two groups and Qmax increased(group A:t=39.3588, 104.5085, 37.9827, 8.8270, group B:t=26.4814, 84.0084, 32.4105, 6.1279, P<0.05). At 6 months after surgery, IPSS score, residual urine volume and QOL score in group A were lower than these in group B and Qmaxin group A was higher than that of group B(t=6.1208, 10.2366, 8.9515, 7.0501, P<0.05). The incidence of urinary incontinence after operation in group A(2.13%) was lower than that in group B(19.15%)(P<0.05). The incidence of sexual dysfunction at 6 months after operation in group A(10.64%) was lower than that in group B(33.40%)(P<0.05). Conclusions Compared with transurethral resection of prostate, transurethral plasma resection of prostate for patients with large volume benign prostatic hyperplasia is of low incidence of postoperative urinary incontinence and sexual dysfunction, which has important research value.
引文
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[10] 熊文清,万建,付明.经尿道前列腺等离子双极电切术治疗大体积良性前列腺增生症疗效观察[J].临床外科杂志,2015,23(10):789-791.
[11] 游猛,吴杰英,陈岳,等.耻骨上前列腺切除与经尿道前列腺电切治疗大体积前列腺增生的比较[J].中华腔镜泌尿外科杂志:电子版,2015,9(3):40-43.
[12] 赵力,沈文浩,印苏培,等.经尿道前列腺电切术治疗大体积良性前列腺增生安全性及有效性的回顾性对照研究[J].中华泌尿外科杂志,2015,36(4):299-303.
[13] 王欢,刘斌,曾枭,等.双极等离子经尿道前列腺电切术治疗大体积前列腺增生的临床疗效[J].中国医师杂志,2017,19(1):116-119.
[14] 盛明雄,万玲玲,刘昌明.经尿道选择性绿激光汽化术与经尿道等离子电切术治疗大体积前列腺增生的比较[J].实用医学杂志,2016,32(23):3890-3893.
[15] 陈咏佳,陈光耀,阮永同,等.经尿道等离子单纯前列腺中叶切除治疗大体积高危前列腺增生症的可行性研究[J].齐齐哈尔医学院学报,2016,37(3):290-291.
[16] 吴刚,黄盛松,吴登龙,等.红激光与等离子经尿道前列腺剜除术治疗大体积良性前列腺增生的疗效及安全性比较[J].外科研究与新技术,2015,4(2):71-74.
[17] 刘宏伟,左玲,柳建军,等.经尿道等离子前列腺剜除术与电切术治疗大体积前列腺增生疗效比较[J].中国男科学杂志,2015,29(11):45-48.
[18] 王忠,陈彦博,陈其,等.经尿道前列腺等离子切除术与钬激光剜除术治疗良性前列腺增生的疗效和安全性比较[J].中华泌尿外科杂志,2014,35(5):349-353.
[2] Al-Khalil S,Boothe D,Durdin T,et al.Interactions between benign prostatic hyperplasia (BPH) and prostate cancer in large prostates:A retrospective data review[J].International Urology & Nephrology,2016,48(1):91-97.
[3] 张菊根.经尿道钬激光前列腺剜除治疗大体积前列腺增生的研究[J].现代中西医结合杂志,2015,24(33):3658-3661.
[4] Kaplan SA.Re:Interactions between benign prostatic hyperplasia (BPH) and prostate cancer in large prostates:A retrospective data review[J].Journal of Urology,2017,197(6):1531-1535.
[5] 王健,贾卓敏,艾星,等.160W绿激光治疗大体积前列腺增生的疗效分析[J].微创泌尿外科杂志,2015,4(5):298-301.
[6] 游猛,吴杰英,陈岳,等.耻骨上前列腺切除与经尿道前列腺电切治疗大体积前列腺增生的比较[J].中华腔镜泌尿外科杂志:电子版,2015,9(3):40-43.
[7] Mao QW,Li PG,Guo DZ,et al.Prostatic arterial embolization for the treatment of lower urinary tract symptoms due to large (>80 mL) benign prostatic hyperplasia:Results of midterm follow-up from Chinese population[J].Bmc Urology,2015,15(1):33-37.
[8] 李树人,郑鸣,蒋庆祥,等.经尿道前列腺钬激光剜除术联合膀胱小切口与经尿道双极等离子前列腺剜除术治疗高危大体积前列腺增生的比较研究[J].中国内镜杂志,2015,21(10):1028-1032.
[9] Arie C,Paulo S,Langer WM,et al.Open suprapubic versus retropubic prostatectomy in the treatment of benign prostatic hyperplasia during resident′s learning curve:A randomized controlled trial[J].International Brazilian Journal of Urology,2016,42(2):284-292.
[10] 熊文清,万建,付明.经尿道前列腺等离子双极电切术治疗大体积良性前列腺增生症疗效观察[J].临床外科杂志,2015,23(10):789-791.
[11] 游猛,吴杰英,陈岳,等.耻骨上前列腺切除与经尿道前列腺电切治疗大体积前列腺增生的比较[J].中华腔镜泌尿外科杂志:电子版,2015,9(3):40-43.
[12] 赵力,沈文浩,印苏培,等.经尿道前列腺电切术治疗大体积良性前列腺增生安全性及有效性的回顾性对照研究[J].中华泌尿外科杂志,2015,36(4):299-303.
[13] 王欢,刘斌,曾枭,等.双极等离子经尿道前列腺电切术治疗大体积前列腺增生的临床疗效[J].中国医师杂志,2017,19(1):116-119.
[14] 盛明雄,万玲玲,刘昌明.经尿道选择性绿激光汽化术与经尿道等离子电切术治疗大体积前列腺增生的比较[J].实用医学杂志,2016,32(23):3890-3893.
[15] 陈咏佳,陈光耀,阮永同,等.经尿道等离子单纯前列腺中叶切除治疗大体积高危前列腺增生症的可行性研究[J].齐齐哈尔医学院学报,2016,37(3):290-291.
[16] 吴刚,黄盛松,吴登龙,等.红激光与等离子经尿道前列腺剜除术治疗大体积良性前列腺增生的疗效及安全性比较[J].外科研究与新技术,2015,4(2):71-74.
[17] 刘宏伟,左玲,柳建军,等.经尿道等离子前列腺剜除术与电切术治疗大体积前列腺增生疗效比较[J].中国男科学杂志,2015,29(11):45-48.
[18] 王忠,陈彦博,陈其,等.经尿道前列腺等离子切除术与钬激光剜除术治疗良性前列腺增生的疗效和安全性比较[J].中华泌尿外科杂志,2014,35(5):349-353.
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