Effect of transurethral plasma kinetic resection of prostate and transurethral vaporization of prostate on benign prostatic hyperplasia and influencing factors of bladder neck contracture after operation

doi:10.3877/cma.j.issn.1674-3253.2022.02.005

Abstract

Abstract:

Objective

To explore the effect of transurethral plasma kinetic resection of prostate (TUPKRP) and transurethral vaporization of prostate (TUVP) in the treatment of benign prostatic hyperplasia (BPH), and to analyze the influencing factors of bladder neck contracture (BNC).

Methods

A prospective study was conducted on 90 BPH patients admitted to the Urology Department of our hospital from January 2018 to January 2020. The patients were randomly divided into the control group (45 patients underwent TUVP) and the observation group (45 patients underwent TUPKRP) by simple numerical random table method. The data of two groups were compared before treatment and 3 months after treatment. The influence factors of postoperative BNC were explored wheather BNC occurred.

Results

After 3 months of treatment, IPSS, PSA, EGF and PGE2 of the 2 groups were lower than that before treatment (P<0.05), and Q_max was higher than that before treatment (P<0.05). After treatment, IPSS, PSA, EGF and PGE2 of the observation group were lower than those of the control group (P<0.05), and Q_max was higher than that of the control group (P<0.05). In BNC group of patients with prostatitis, washing temperature <34 ℃, catheter perfusion ≥40 ml and TUVP proportion were significantly higher than without BNC group of patients (P<0.05). Logistic analysis showed that complications of prostatitis, flushing temperature <34℃, catheter perfusion ≥40 ml, and TUVP were independent risk factors for BNC after operation (P<0.05).

Conclusion

Both TUVP and TUPKRP could improve the clinical symptoms of the patients, but TUPKRP had a better effect. However, the combination of prostatitis, flushing temperature <34℃, catheter perfusion ≥40 ml, and TUVP were independent risk factors of BNC.

Key words: BPH, TUPKRP, TUVP, BNC

Bin Shi, Keyu Chen. Effect of transurethral plasma kinetic resection of prostate and transurethral vaporization of prostate on benign prostatic hyperplasia and influencing factors of bladder neck contracture after operation[J]. Chinese Journal of Endourology(Electronic Edition), 2022, 16(02): 116-119.

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References 15

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组别	时间	IPSS（分）	Q_max（ml/s）	PSA（ng/ml）	EGF（pg/ml）	PGE2（ng/ml）
TUPKRP组（n=45）	治疗前	21.13±6.21	8.04±1.69	6.5±1.06	46.26±13.25.	2.60±0.42
TUPKRP组（n=45）	治疗3个月	4.04±0.66	28.72±6.720	1.59±0.49	22.04±6.83	0.99±0.15
TUVP组（n=45）	治疗前	22.18±6.26	8.08±1.75	6.46±1.08	47.15±13.39	2.65±0.38
TUVP组（n=45）	治疗3个月	7.32±1.13	21.1±6.05	2.39±0.49	31.55±7.16	1.44±0.29
t值		16.853	5.771	7.963	6.628	7.639
P值		<0.001	<0.001	<0.001	<0.001	<0.001

组别	时间	IPSS（分）	Q_max（ml/s）	PSA（ng/ml）	EGF（pg/ml）	PGE2（ng/ml）
TUPKRP组（n=45）	治疗前	21.13±6.21	8.04±1.69	6.5±1.06	46.26±13.25.	2.60±0.42
TUPKRP组（n=45）	治疗3个月	4.04±0.66	28.72±6.720	1.59±0.49	22.04±6.83	0.99±0.15
TUVP组（n=45）	治疗前	22.18±6.26	8.08±1.75	6.46±1.08	47.15±13.39	2.65±0.38
TUVP组（n=45）	治疗3个月	7.32±1.13	21.1±6.05	2.39±0.49	31.55±7.16	1.44±0.29
t值		16.853	5.771	7.963	6.628	7.639
P值		<0.001	<0.001	<0.001	<0.001	<0.001

组别	例数	年龄（例）		高血压(例)	糖尿病(例)	冠心病(例)	尿潴留(例)	合并前列腺炎(例)	前列腺增生程度(例)			病程(年)
组别	例数	≤65岁	>65岁	高血压(例)	糖尿病(例)	冠心病(例)	尿潴留(例)	合并前列腺炎(例)	Ⅰ度	Ⅱ度	Ⅲ度	病程(年)
未发生BNC	70	38	32	11	8	7	6	10	38	2	12	62.8±5.1
发生BNC	20	12	8	3	4	5	4	11	10	7	3	62.9±5.3
统计值		χ²=0.206		χ²=0.006	χ²=0.989	χ²=3.029	χ²=2.057	χ²=14.414	χ²=0.068			t=0.107
P值		0.650		0.938	0.320	0.082	0.151	<0.001	0.795			0.915
组别	IPSS(分)	Q_max(ml/s)	PSA(ng/ml)	EGF(pg/ml)	PGE2(ng/ml)	冲洗温度(例)		导管灌注量(例)		术式(例)
组别	IPSS(分)	Q_max(ml/s)	PSA(ng/ml)	EGF(pg/ml)	PGE2(ng/ml)	<34℃	>34℃	≥40 ml	<40 ml	TUPKRP	TUVP
未发生BNC	7.00±1.43	21.56±6.73	8.12±1.82	6.47±1.04	47.03±13.27	10	60	12	58	39	31
发生BNC	7.20±1.36	22.03±6.33	8.04±1.79	6.61±1.13	46.57±14.52	13	7	15	5	6	14
统计值	t=0.557	t=0.279	t=0.174	t=0.521	t=0.134	χ²=21.029		χ²=24.796		χ²=4.114
P值	0.579	0.781	0.862	0.604	0.894	<0.001		<0.001		0.043

组别	例数	年龄（例）		高血压(例)	糖尿病(例)	冠心病(例)	尿潴留(例)	合并前列腺炎(例)	前列腺增生程度(例)			病程(年)
组别	例数	≤65岁	>65岁	高血压(例)	糖尿病(例)	冠心病(例)	尿潴留(例)	合并前列腺炎(例)	Ⅰ度	Ⅱ度	Ⅲ度	病程(年)
未发生BNC	70	38	32	11	8	7	6	10	38	2	12	62.8±5.1
发生BNC	20	12	8	3	4	5	4	11	10	7	3	62.9±5.3
统计值		χ²=0.206		χ²=0.006	χ²=0.989	χ²=3.029	χ²=2.057	χ²=14.414	χ²=0.068			t=0.107
P值		0.650		0.938	0.320	0.082	0.151	<0.001	0.795			0.915
组别	IPSS(分)	Q_max(ml/s)	PSA(ng/ml)	EGF(pg/ml)	PGE2(ng/ml)	冲洗温度(例)		导管灌注量(例)		术式(例)
组别	IPSS(分)	Q_max(ml/s)	PSA(ng/ml)	EGF(pg/ml)	PGE2(ng/ml)	<34℃	>34℃	≥40 ml	<40 ml	TUPKRP	TUVP
未发生BNC	7.00±1.43	21.56±6.73	8.12±1.82	6.47±1.04	47.03±13.27	10	60	12	58	39	31
发生BNC	7.20±1.36	22.03±6.33	8.04±1.79	6.61±1.13	46.57±14.52	13	7	15	5	6	14
统计值	t=0.557	t=0.279	t=0.174	t=0.521	t=0.134	χ²=21.029		χ²=24.796		χ²=4.114
P值	0.579	0.781	0.862	0.604	0.894	<0.001		<0.001		0.043

因子	B	S.E.	Wald	显著性	Exp(B)	95%CI置信区间
因子	B	S.E.	Wald	显著性	Exp(B)	下限	上限
合并前列腺炎	1.625	0.608	7.146	0.008	5.081	1.543	16.729
冲洗温度<34℃	1.420	0.653	4.731	0.030	4.137	1.151	14.871
导管灌注量≥40 ml	1.709	0.704	5.888	0.015	5.521	1.389	21.950
TUVP	2.394	0.776	9.527	0.002	10.959	2.396	50.122

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