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目的探讨经尿道120W绿激光前列腺汽化术(PVP)治疗良性前列腺增生(BPH)和前列腺腺癌导致膀胱出口梗阻的有效性、安全性及对性功能的影响。方法应用PVP治疗BPH98例和前列腺腺癌4例,对手术时间,术后留置尿管时间,手术前后血清钠,血红蛋白,国际前列腺症状评分(I-PSS),生活质量评分(QOL),最大尿流率(Qmax);国际阴茎勃起功能问卷表(IIEF-5)评分,性欲减退、逆行射精及阴茎勃起硬度下降等指标进行评价。结果 75例单用PVP顺利完成手术,27例用等离子双极电切辅助完成手术,手术时间34~196min(53.2±34.1);术后平均留置尿管58.4±3.7小时;血清钠、血红蛋白,IIEF-5,性欲减退,阴茎勃起硬度下降手术前后比较差异无统计学意义(P>0.05);I-PSS,QOL,Qmax,逆行射精手术前后比较差异有统计学意义(P<0.05)。结论经尿道120W绿激光前列腺汽化术(PVP)治疗良性前列腺增生(BPH)和前列腺腺癌导致膀胱出口梗阻有效,安全,对性功能无明显影响。
Objective To investigate the efficacy, safety and sexual function of transurethral 120W green laser prostatic vaporization (PVP) in the treatment of benign prostatic hyperplasia (BPH) and prostatic adenocarcinoma caused by bladder outlet obstruction. Methods PVP was used to treat BPH in 98 cases and prostatic adenocarcinoma in 4 cases. The time of operation, the duration of indwelling catheter, serum sodium, hemoglobin, I-PSS, QOL, Flow rate (Qmax); International Penile Erection Questionnaire (IIEF-5) score, loss of libido, retrograde ejaculation and penile erection hardness and other indicators were evaluated. Results The operation of PVP was completed successfully in 75 patients with PVP alone. Twenty - seven patients were assisted by plasma bipolar electrosurgical excision. The operation time was 34 to 196 minutes (53.2 ± 34.1). The average postoperative urinary catheter was 58.4 ± 3.7 hours. Serum sodium, hemoglobin, IIEF -5, decreased libido and penile erection hardness had no significant difference before and after operation (P> 0.05). There were significant differences in I-PSS, QOL, Qmax and retrograde ejaculation before and after operation (P <0.05). Conclusions Transurethral vapor laser photocoagulation (PVP) of benign prostatic hyperplasia (BPH) and prostate adenocarcinoma caused by transurethral resection of 120W green laser is effective and safe in bladder outlet obstruction, and has no significant effect on sexual function.