Clinical Outcome of Endoscopic Enucleation of the Prostate Compared With Robotic-Assisted Simple Prostatectomy for Prostates Larger Than 80 cm3 in Aging Male

被引:10
作者
Hou, Chen-Pang [1 ,2 ,3 ]
Lin, Yu-Hsiang [1 ,2 ,3 ]
Yang, Pei-Shan [1 ,3 ]
Chang, Phei-Lang [1 ,3 ]
Chen, Chien-Lun [1 ,3 ]
Lin, Kuo-Yen [1 ,3 ]
Juang, Horng-Heng [1 ,4 ]
Weng, Shu-Chuan [5 ]
Tsui, Ke-Hung [6 ,7 ,8 ]
机构
[1] Chang Gung Mem Hosp Linkou, Dept Urol, Taoyuan, Taiwan
[2] Chang Gung Univ, Coll Med, Grad Inst Clin Med Sci, Taoyuan, Taiwan
[3] Chang Gung Univ, Sch Med, Taoyuan, Taiwan
[4] Chang Gung Univ, Sch Med, Dept Anat, Taoyuan, Taiwan
[5] Yuanpei Univ Med Technol, Bachelor Degree Program Senior Hlth & Management, Hsinchu, Taiwan
[6] Taipei Med Univ, Coll Med, Sch Med, Dept Urol, Taipei, Taiwan
[7] Taipei Med Univ, Shuang Ho Hosp, Dept Urol, New Taipei 110, Taiwan
[8] Taipei Med Univ, TMU Res Ctr Urol & Kidney TMU RCUK, Taipei, Taiwan
基金
美国国家科学基金会;
关键词
prostate hypertrophy; laser; robotic surgery; outcome; URINARY-TRACT SYMPTOMS; TRANSURETHRAL RESECTION; LASER ENUCLEATION; HIGH-VOLUME; BENIGN; HYPERPLASIA; GUIDELINES; DEPTH;
D O I
10.1177/15579883211064128
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
This study investigated and compared the surgical outcomes of using endoscopic enucleation (thulium: YAG laser and bipolar plasma; ThuLEP) with robotic-assisted simple prostatectomy (RASP) in the treatment of prostates larger than 80 cm(3). Records were obtained for the period from January 2014 to December 2020 for selected patients with BPO who underwent RASP, ThuLEP, or bipolar transurethral enucleation of the prostate (B-TUEP). Patients were excluded if they had active malignant disease, neurogenic bladder, lower urinary tract syndrome for reasons other than BPO, and a history of prostate surgery. Data of 396 patients who underwent B-TUEP, ThuLEP, and RASP were examined. A total of 112 patients met the including criteria, 85 of whom (B-TUEP: 29; ThuLEP: 41; RASP: 15) completed the final visit. The mean operation time and duration of postoperative hospital stays in the RASP group were significantly longer than those of the B-TUEP and ThuLEP groups. Only 1 patient in the RASP group required blood transfusion. The RASP group was superior to the other groups in voiding improvement including Qmax and IPSS voiding score. The pain score of the ThuLEP group after surgery was significantly lower than that of the other two groups during hospitalization, whereas the QoL scores were identical between the three groups at 2 weeks, 3 months, and 6 months post operation. The rates of returning to ER within the first postoperative month did not differ significantly between the three groups, and all the reasons for return involved minor complications that required no additional invasive treatment. These three surgical methods (B-TUEP, ThuLEP, and RASP) are all effective and safe for treating prostates larger than 80 cm3, with each having its particular advantages. B-TUEP requires the shortest operation time, ThuLEP causes the lowest postoperative pain, and RASP results in superior voiding function improvement.
引用
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页数:10
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