经前列腺段尿道黏膜下绿激光汽化术治疗良性前列腺增生的安全性和疗效分析  

Safety and efficacy analysis of transprostatic urethral submucosa vaporization treatment by green laser drilling for benign prostatic hyperplasia

作　　者：王继业[1] 陈世康 孙康龙 张建华[1] 汪威[1] WANG Jiye;CHEN Shikang;SUN Kanglong(Department of Urology,Tiantai County People's Hospital,Tiantai 317200,China)

机构地区：[1]天台县人民医院泌尿外科,浙江天台317200

出　　处：《全科医学临床与教育》2025年第3期215-218,F0003,共5页Clinical Education of General Practice

摘　　要：目的 探讨经前列腺段尿道黏膜下绿激光汽化术(TUSVT-GLD)治疗良性前列腺增生的安全性和疗效。方法 选取经超声及临床诊断良性前列腺增生患者21例,均采用TUSVT-GLD手术方案治疗,评估术式的疗效与安全性,比较术前术后患者的国际前列腺症状评分(IPSS)评分、最大尿流率(Qmax)、生活质量评分(QoL)及前列腺体积等指标。结果 21例患者术后留置导尿管1~5 d,平均留置时间(2.95±0.74)d,其中术后3 d内拔除导尿管后自行通畅排尿19例(90.14%),所有患者未发生再次尿潴留,无明显血尿。术后3个月随访,均无尿失禁和排尿困难,只有1例(4.76%)发生逆行射精;TUSVT-GLD术后患者的IPSS评分和QoL评分低于术前,Qmax高于术前,差异均有统计学意义(t分别=6.56、14.95、-8.15,P均<0.05);术后患者的前列腺体积与术前比较,差异无统计学意义(t=2.01,P>0.05)。结论 TUSVT-GLD术后排尿功能改善明显,且能有效降低术后尿失禁、膀胱颈口挛缩、逆行射精的发生,在术后安全性上展现出优势。Objective To investigate the safety and efficacy of transprostatic urethral submucosa vaporization treatment by green laser drilling(TUSVT-GLD)for benign prostatic hyperplasia.Methods Twenty-one patients with benign prostatic hyperplasia diagnosed by ultrasound and clinical diagnosis were selected,all of which were treated with TUSVTGLD surgical protocol.The efficacy and safety of the surgical method were evaluated,and the international prostatic symptom score(IPSS)score,maximum urinary flow rate(Qmax),quality of life score(QoL)and prostate volume of the patients were compared before and after surgery.Results All patients underwent indwelling urinary catheterization for 1-5days after surgery,with an average indwelling time of(2.95±0.74)days.Among them,19 patients(90.14%)underwent spontaneous unblocked urination after catheter removal within 3 days after surgery.All patients had no urinary retention again and no obvious hematuria.During the 3-month follow-up after surgery,there was no urinary incontinence or difficulty urinating,and only 1 case(4.76%)had retrograde ejaculation.The IPSS score and QoL score of TUSVT-GLD patients after operation were lower than before operation,and Qmax was higher than before operation(t=6.56,14.95,-8.15,P<0.05).The difference in prostate volume of patients before and after surgery was not statistically significant(t=2.01,P>0.05).Conclusion TUSVT-GLD showed significant improvement in postoperative urination function,and could effectively reduce the occurrence of postoperative urinary incontinence,bladder neck contracture,and retrograde ejaculation,It has advantages in postoperative safety.

关 键 词：经前列腺段尿道黏膜下绿激光汽化术 前列腺增生 绿激光 

分 类 号：R69[医药卫生—泌尿科学]