Objective: To compare and analyze the effects of transurethral resection of the prostate (TURP) and transurethral holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH) with bladder detrusor overactivity.
Methods: his study included 51 cases of BPH with bladder detrusor overactivity treated by TURP and another 58 treated by HoLEP. We evaluated the urination of the two groups of patients during the recovery period and at 3 and 6 months postoperatively.
Results: There were no statistically significant differences in such baseline data as the blood PSA level, prostate volume, International Prostate Symptom Score (IPSS), and quality of life (QOL) between the two groups of patients, except in effective bladder capacity, which was higher in the TURP than in the HoLEP group (［315±59］ vs ［287±76］ ml, P<0.05). Urine storage symptoms were obviously improved in both of the groups postoperatively, with the storage symptoms score significantly decreased from 12.6±4.9 preoperatively to 7.5±3.9 at 3 months and 6.1±4.2 at 6 months after surgery in the TURP group (P<0.01) and from 13.7±5.7 to 7.9±4.2 and 7.0±5.1 in the HoLEP group (P<0.01). HoLEP manifested significant advantages over TURP in the postoperative urethral catheterization time (［2.7±0.8］ vs ［5.1±1.2］ d, P<0.05), postoperative bladder contracture time (［4.1±1.9］ vs ［5.8±2.4］ d, P<0.05), postoperative hospital stay (［4.4±1.8］ vs ［5.9±2.5］ d, P<0.05), and improvement of the maximum urinary flow rate, which was increased from (7.9±3.7) ml/s preoperatively to (16.8±4.3) ml/s at 3 months after surgery in the HoLEP group and from (8.6±3.2) ml/s to (14.6±4.3) ml/s in the TURP group (P<0.05).
Conclusions: Both TURP and HoLEP can improve bladder function and detrusor overactivity in BPH patients, with similar effects in improving urination at 3 to 6 months after surgery. However, HoLEP has more advantages over TURP during the period of postoperative recovery.
目的： 比较分析经尿道前列腺电切术(TURP)及经尿道钬激光前列腺剜除术（HoLEP）对合并膀胱逼尿肌活动过度的良性前列腺增生(BPH)的手术效果。 方法：入组患者均为BPH合并膀胱逼尿肌活动过度，51例采用TURP，58例采用HoLEP，评估两组患者在术后恢复期及术后3、6个月的排尿情况。 结果： 两组患者术前血PSA水平、前列腺体积、国际前列腺症状评分（IPSS）、生活质量(QoL)评分无显著差异，但是膀胱有效容量TURP组［（315±59） ml］优于HoLEP组［（287±76） ml］（P<0.05）。术后评估两组患者储尿期症状均改善明显，TURP组IPSS评分中，储尿期评分从术前的（12.6±4.9）分降低到术后3个月的（7.5±3.9）分和术后6个月的（6.1±4.2）分；HoLEP组储尿期评分从术前的（13.7±5.7）分降低到术后3个月的（7.9±4.2）分和术后6个月的(7.0±5.1)分，均有显著性差异（P均<0.01）。HoLEP组术后留置导尿管天数［（2.7±0.8） d vs （5.1±1.2） d］、术后膀胱挛缩天数［（4.1±1.9） d vs （5.8±2.4） d］、术后住院天数［（4.4±1.8） d vs （5.9±2.5） d］、术后3个月患者最大尿流率的改善情况［HoLEP组术前为( 7.9±3.7) ml/s，术后3个月为(16.8±4.3) ml/s；TURP组术前为（8.6±3.2） ml/s，术后3个月为（14.6±4.3） ml/s］均优于TURP组，差异均有统计学意义（P均<0.05）。 结论： TURP和HoLEP均能改善膀胱功能和膀胱逼尿肌活动过度，在术后恢复期内，HoLEP手术较有优势，但是在术后3个月及术后6个月，两组手术改善排尿情况接近。.
Keywords: benign prostatic hyperplasia; bladder detrusor overactivity; transurethral holmium laser enucleation of the prostate; transurethral resection of the prostate.