Objective: To compare thulium laser vaporization of the prostate (TLVP) and transurethral resection of the prostate (TURP) in the treatment of benign prostate hyperplasia (BPH) analyze the risk factors for postoperative urethral stricture.
Methods: From June 2015 to June 2016, 210 BPH patients in our hospital underwent TURP (n = 126) or TLVP (n = 84). We followed up the patients for 6 months, compared the effects of the two surgical strategies and analyzed the risk factors for postoperative urethral stricture by multivariate logistic regression analysis.
Results: Compared with TURP, TLVP achieved significantly shorter time of operation (［78.6 ± 27.5］ vs ［53.2 ± 21.6］ min, P <0.01), postoperative bladder irrigation (［31.5 ± 2.9］ vs ［26.1 ± 3.7］ h, P <0.01), urethral catheterization (［5.3 ± 1.7］ vs ［3.7 ± 1.5］ d, P <0.01) and postoperative hospitalization (［7.9 ± 2.1］ vs ［5.5 ± 1.4］ d, P <0.01) as well as lower urinary leukocyte count at 6 months after surgery (［32.1 ± 12.6］ vs ［24.9 ± 11.7］ /μl, P <0.01) and incidence rate of postoperative complications (11.9% ［15/126］ vs 3.6% ［3/84］, P <0.05), particularly that of urethral stricture (7.9% ［10/126］ vs 1.2% ［1/84］, P <0.05). Logistic regression analysis showed that the preoperative urinary leukocyte count, postoperative urethral catheterization time, and surgical method were independent risk factors for postoperative urethral stricture.
Conclusions: TLVP, in comparison with TURP, has the advantages of definite effect, fast recovery, high safety and low incidence of postoperative urethral stricture. The main risk factors for postoperative urethral stricture include preoperative urinary tract infection, postoperative urethral catheterization time and surgical method.
目的: 比较铥激光前列腺汽化切除术与经尿道前列腺电切术(TURP)术疗效及术后尿道狭窄相关因素分析。 方法: 收集2015年6月至2016年6月我院接受手术治疗的BPH患者210例，分为TURP组(n=126)和铥激光组(n=84)，分别应用TURP和铥激光治疗，对比两种术式的治疗效果；术后随访半年，应用Logistic 回归分析术后半年发生尿道狭窄的危险因素。 结果: 铥激光组患者的手术时间（53.2±21.6） min与TURP组患者（78.6±27.5） min相比明显缩短，术后膀胱冲洗时间（26.1±3.7） h与TURP组患者（31.5±2.9） h相比明显缩短，留置尿管时间（3.7±1.5）d与TURP组患者（5.3±1.7） d相比明显缩短，术后住院时间（5.5±1.4）d与TURP组患者（7.9±2.1）d相比也明显缩短，术后6个月尿白细胞铥激光组（24.9±11.7）个/μl较TURP组(32.1±12.6）个/μl更少，术后并发症发生率铥激光组（3.6%，3/84）较TURP组（11.9%，15/126)更低，其中尿道狭窄发生率铥激光组（1.2%，1/84）较TURP组（7.9%，10/126）明显更低，差异有统计学意义（P<0.05）；Logistic 回归分析显示术前尿白细胞数、术后留置尿管时间、手术方式是术后尿道狭窄的独立危险因素。 结论： 铥激光手术相比TURP，疗效确切，术后恢复快，安全性高，术后尿道狭窄发生率低，术后尿道狭窄的主要风险因素有尿路感染、术后留置尿管时间及手术方式，应注意选择最佳术式、术后合理置管及预防尿道感染，从而减少尿道狭窄的发生。.
Keywords: risk factors; transurethral resection of the prostate; urethral stricture; thulium laser vaporization of the prostate.