Transurethral resection of the prostate: one-year experience in a single centre

Background: Benign prostatic hyperplasia (BPH) is the most common cause of lower urinary tract symptoms among older males. Transurethral resection of the prostate (TURP) still remains the gold standard in the treatment of benign prostatic hyperplasia. However, its availability is not widespread in most public healthcare facilities across sub-Saharan Africa. This study was designed to describe and share our experience of TURP in a single centre. Methods: This is a retrospective evaluation of 64 patients who had TURP for bladder outlet obstruction secondary to enlarged prostate. The records of men who had TURP over a period of one year (January 2022-December 2022) were retrieved and reviewed. The pre-operative prostate specific antigen (PSA), pre-operative ultrasound measured size of prostate, resected weight of prostate, duration of surgery, duration of hospital stay, indication for TURP and complications were analysed. Results: Sixty-four patients had TURP done during the period under review. The age range was 50-90 years (mean 68.33), the pre-operative prostate gland weight was 76.78gm. The mean resected weight was 53.9gm. The pre-operative serum prostate specific antigen PSA had a minimum value of 1.5ng/ml and the maximum was 50.8ng/ml with mean value of 13.8ng/ml. The mean duration of surgery was 55.73 minutes and the mean duration of hospital stay was 3 days. The most common indication for TURP was lower urinary tract symptoms. We recorded four complications; capsule perforation, clot retention, hypotension and stress incontinence, 60 patients had no complications. Conclusions: Transurethral resection of the prostate is an effective surgical treatment for benign prostatic hyperplasia, it is associated notable improvement in the patient抯 quality of life and minimal complications.

Comparison of tamsulosin hydrochloride versus tamsulosin hydrochloride and deflazacort in relieving postoperative urinary retention in patients undergoing transurethral resection of prostate: a prospective randomized controlled trial in a tertiary care centre

Background: Benign prostatic hyperplasia (BPH) is common amongst the elderly. Even after transurethral resection of prostate (TURP), retention of urine may persist in some leading to significant morbidity adversely affecting the quality of life. The role of alpha blockers in this situation as a combination is unclear. The present study was conducted to evaluate and compare the efficacy of tamsulosin versus tamsulosin and deflazacort in relieving the postoperative retention of urine following TURP. Methods: After obtaining ethics approval and written informed consent, 72 patients satisfying the eligibility criteria were included. After TURP, patients with urinary retention following catheter removal were randomized into group A (tamsulosin hydrochloride) and group B (tamsulosin hydrochloride and deflazocort). baseline international prostate symptom score (IPSS) score was done to assess quality of life and findings of radiological investigations were noted. Thereafter, medical therapy was done as per assigned group and postoperative findings were documented and analyzed. Results: Both the groups were similar in terms of demographic characteristics and baseline characteristics. The relief of symptoms was significantly more in group B along with lower IPSS score and residual volume. Conclusions: We recommend addition of deflazacort to tamsulosin hydrochloride as medical therapy for the management of postoperative retention of urine (POUR), especially following TURP.

Lower urinary tract symptoms evaluation with uroflowmetry in patients with benign prostatic hyperplasia

Background: Uroflowmetry, a non-invasive urodynamic technique, is commonly employed in evaluating patients with potential lower urinary tract dysfunction. Accurate assessment of the severity of lower urinary tract symptoms (LUTS) can be achieved through the utilization of various validated questionnaires, such as the International Prostate Symptom Score (IPSS). The objective of this study was to investigate the correlation between uroflowmetry parameters and the severity of symptoms. Methods: Fifty patients with LUTS caused by benign prostatic hyperplasia were evaluated by using uroflowmetry, IPSS, prostate volume estimation from May 2022 to December 2023. The correlations between these parameters were quantified by means of Spearman correlation co-efficients. Results: Significant statistical correlations were identified between the IPSS and uroflowmetry outcomes, including peak flow rate, average flow rate, and post-void residual urine. However, no correlation was observed between the IPSS and measurements of prostate volume. Conclusions: A positive correlation was observed between the measured peak flow rate through uroflowmetry and the severity of lower urinary tract symptoms.

Efficacy of 450 nm blue laser with 6 o’clock positioning in the treatment of middle lobe hyperplasia of prostate / 现代泌尿外科杂志

【Objective】 To investigate the efficacy and safety of 450 nm blue laser with 6 o’clock positioning in the treatment of middle lobe hyperplasia of prostate, in order to promote the clinical application of this surgery. 【Methods】 Clinical data of 20 patients with middle lobe hyperplasia of prostate treated with 450 nm blue laser with 6 o’clock positioning during Mar.and Aug.2023 were retrospectively analyzed.The operation time, postoperative bladder irrigation time, catheter indwelling time, hospital stay, and complications were recorded.The maximum urinary flow rate (Qmax), post-void residual volume (PVR), quality of life scale (QoL), international prostate symptom score (IPSS) before surgery and 1 month after surgery were compared. 【Results】 The operation time was (26.80±7.22) min, and bladder irrigation time was (20.50±1.79) h.The catheter was removed on the next day after surgery and all patients were discharged 2 days after operation.Compared to preoperative, one month after surgery, the Qmax [(7.40±1.05) mL/s vs.(19.60±1.76) mL/s] was significantly higher, PVR [(73.50±12.26) mL vs.(9.25±4.94) mL], QoL [(4.55±1.19) vs.(1.95±0.95)], and IPSS [(26.55±1.88) vs.(10.05±1.36)] were significantly lower, the differences being statistically significant (P<0.05).No complications occurred during operation and 1-month follow-up. 【Conclusion】 The 450 nm blue laser with 6 o’clock positioning is a new, safe and effective surgical treatment of middle lobe hyperplasia of prostate, which is worthy of clinical promotion and application.

Clinical application of transurethral 450 nm blue laser vaporization in the treatment of benign prostatic hyperplasia in district hospitals / 现代泌尿外科杂志

【Objective】 To investigate the application value of 450 nm blue laser vaporization in the treatment of benign prostatic hyperplasia (BPH) in district hospitals, so as to provide reference for the selection of BPH treatment methods in district-level hospitals. 【Methods】 The clinical data of 39 BPH patients who received surgical treatment in Chang’an Hospital during Jan.and Sep.2023 were retrospectively analyzed.The patients were divided into two groups, including 19 in blue laser group treated with 450 nm blue laser vaporization and 20 in the TURP group treated with transurethral resection of the prostate (TURP).The operation time, hemoglobin decline, postoperative bladder irrigation time, catheter indwelling time and adverse events were compared between the two groups. 【Results】 All operations were successfully completed.In the blue laser group, the operation time [(45.11±22.08) min vs.(81.25±29.37) min], postoperative bladder irrigation time [(34.05±9.41) h vs.(47.60±9.05) h] and the decrease of hemoglobin [(7.79± 5.86) g/L vs.(16.40±10.23) g/L] were significantly lower than those in the TURP group (P0.05). 【Conclusion】 The 450 nm blue laser vaporization of prostate has advantages of less blood loss, shorter operation time and shorter postoperative irrigation time.Therefore, it should be considered as a preferable option for BPH in primary hospitals.

Effects of body mass index and serum lipid levels on prostate volume in patients with benign prostatic hyperplasia / 现代泌尿外科杂志

【Objective】 To explore the correlation between body mass index (BMI) and lipid indexes with prostate volume in patients with benign prostatic hyperplasia (BPH) so as to provide reference for the clinical prevention of this disease. 【Methods】 Clinical data of 578 patients admitted to the Department of Urology of Chinese PLA General Hospital during Jan.2014 and Dec.2022 were collected.The patients underwent initial prostate puncture biopsy or prostatectomy and BPH was confirmed pathologically.The patients’ age, time of onset of the disease, BMI, past medical history and biochemical indexes were analyzed.According to the total prostate volume (TPV) grading, the patients were divided into TPV>75 mL and TPV≤75 mL groups.The general data of the two groups were compared, and predictors of TPV were determined with linear regression analysis.The samples were stratified with BMI to observe the differences in the effects of apolipoprotein B (ApoB) on TPV. 【Results】 There were 215 cases in the TPV>75 mL group and 363 cases in the TPV≤75 mL group.The levels of BMI, triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and apolipoprotein B (ApoB) were higher in the TPV>75 mL group (P0.05), and ApoB predicted prostate volume growth in overweight and obese BPH population respectively (β=26.411, P=0.011; β=47.602, P=0.017). 【Conclusion】 Age, ApoB and BMI can be used as predictors of volume growth in BPH patients, which can help further research on the pathogenesis and progression of BPH.

Clinical Efficacy of Fuzheng Huaji Longbi Decoction in Treating Benign Prostatic Hyperplasia with Syndrome of Healthy Qi Deficiency and Blood Stasis / 中国实验方剂学杂志

ObjectiveTo explore the clinical efficacy and safety of Fuzheng Huaji Longbi decoction in treating benign prostatic hyperplasia （BPH） in the patients with the syndrome of healthy Qi deficiency and blood stasis. MethodA total of 94 BPH patients were randomized into control and observation groups， with 47 patients in each group. The control group was treated with doxazosin mesylate sustained-release tablets， and the observation group with Fuzheng Huaji Longbi decoction on the basis of the therapy in the control group. After eight weeks， the international prostate symptom score （IPSS）， quality of life （QOL） score， residual urine volume （RUV）， maximum urinary flow rate （Qmax）， TCM syndrome score， TCM symptom score， electrocardiogram， and liver and kidney function were determined to evaluate the clinical efficacy and safety of the two groups. ResultAfter 8 weeks of treatment， the total response rate in the control group was 63.64% （28/44）， which was lower than that （84.44%， 38/45） in the observation group （χ2=5.026， P<0.05）. The clinical efficacy in the observation group was higher than that in the control group （Z=-2.17， P=0.030）. The treatment in both groups decreased the IPSS， QOL score， RUV， and TCM syndrome scores and increased the Qmax （P<0.05）. Moreover， the observation group had lower IPSS， QOL score， RUV， and TCM syndrome score （P<0.05） and higher Qmax than the control group after treatment （P<0.05）. The treatment in the observation group decreased all the TCM symptom scores （P<0.05）， while that in the control group only decreased the frequency of urination at night and the scores of dysuria， weak urine stream， and post-urinary drainage （P<0.05）. After treatment， the observation group had lower frequency of urination at night and lower scores of mental fatigue， cold limbs， lower abdominal discomfort， and loose stool than the control group （P<0.05）. No adverse events associated with the administration of Fuzheng Huaji Longbi decoction were observed during the treatment period. ConclusionFuzheng Huaji Longbi decoction is effective in treating BPH in the patients with the syndrome of healthy qi deficiency and blood stasis. It can relieve the clinical symptoms and improve the quality of life， being a safe and reliable choice for clinical application.

Metformin:A promising clinical therapeutical approach for BPH treatment via inhibiting dysregulated steroid hormones-induced prostatic epithelial cells proliferation / 药物分析学报

The occurrence of benign prostate hyperplasia(BPH)was related to disrupted sex steroid hormones,and metformin(Met)had a clinical response to sex steroid hormone-related gynaecological disease.How-ever,whether Met exerts an antiproliferative effect on BPH via sex steroid hormones remains unclear.Here,our clinical study showed that along with prostatic epithelial cell(PEC)proliferation,sex steroid hormones were dysregulated in the serum and prostate of BPH patients.As the major contributor to dysregulated sex steroid hormones,elevated dihydrotestosterone(DHT)had a significant positive rela-tionship with the clinical characteristics of BPH patients.Activation of adenosine 5'-monophosphate(AMP)-activated protein kinase(AMPK)by Met restored dysregulated sex steroid hormone homeostasis and exerted antiproliferative effects against DHT-induced proliferation by inhibiting the formation of androgen receptor(AR)-mediated Yes-associated protein(YAP1)-TEA domain transcription factor(TEAD4)heterodimers.Met's anti-proliferative effects were blocked by AMPK inhibitor or YAP1 over-expression in DHT-cultured BPH-1 cells.Our findings indicated that Met would be a promising clinical therapeutic approach for BPH by inhibiting dysregulated steroid hormone-induced PEC proliferation.

Effects of 1 470 nm Semiconductor Laser on Vaporization Ablation, Cutting, and Coagulation in Ex Vivo Animal Tissue / 实验动物与比较医学

Objective To observe the effects of a 1 470 nm semiconductor laser on vaporization cutting, coagulation, and thermal injury of ex vivo animal tissues, aiming to explore the feasibility of its application in the treatment of benign prostatic hyperplasia.Methods The experimental group and control group were treated with HANS-D1 and ML-DD01FI 1 470 nm semiconductor laser therapy equipment, respectively. Fresh ex vivo pig bladder tissue was exposed to lasers with the optical fiber placed at distances of 0.5 cm and 1 cm from the tissue for 5 s. The effects of layers at powers of 60, 90, 120, 150, and 160 W on tissue injury were observed. Ex vivo dog prostate and pig kidney tissues were used for vaporization ablation and cutting to observe the effects of lasers at the same power levels on tissue vaporization and cutting thermal injury. Additionally, in coagulation mode, the effects of 30, 40, and 50 W semiconductor lasers on tissue coagulation were observed after irradiating ex vivo pig kidney tissue for 5, 10, and 15 seconds. Results When the optical fiber was placed 1 cm away from the tissue, the 1 470 nm semiconductor lasers did not cause accidental damage to adjacent normal bladder tissue. However, at a distance of 0.5 cm, the 120 W, 150 W, or 160 W lasers caused slight damage to the bladder tissue. In addition, with the increase in output power, the vaporization ablation efficiency of 60-160 W lasers on dog prostate tissue gradually increased, showing a good linear correlation between vaporization volume and total energy consumption (P<0.001). Histopathological HE staining results indicated that the coagulation layer thickness in the experimental group was 292.20-309.98 µm, and the vaporization layer depth was 1.49-4.52 mm. In the control group, the coagulation layer thickness was 289.91-303.53 µm, and the vaporization layer depth was 1.88-4.43 mm. There was no significant difference between the two groups (P>0.05). Moreover, when performing vaporization cutting on ex vivo pig kidney tissue with a cross-sectional area of 1 cm2, the efficiency of vaporization cutting by the 60-160 W 1 470 nm semiconductor lasers increased with the increase in output power (P<0.05). The coagulated layer thickness in the experimental group was 496.04-514.47 µm, while that in the control group was 489.39-518.53 µm. Additionally, in coagulation mode, when ex vivo pig kidney tissue was irradiated for 5, 10, and 15 s with 30, 40, and 50 W semiconductor lasers, the coagulation diameter, groove depth, and coagulation efficiency gradually increased with the increase in laser output power (P<0.05). The coagulation layer thickness in the experimental group and control group was 399.10-449.98 µm and 392.97-447.65 µm, respectively, and the vaporization layer depth was 3.05-7.09 mm and 2.70-7.14 mm, respectively. There was no significant difference between the two groups (P>0.05).Conclusion The 1 470 nm semiconductor laser shows good vaporization ablation, cutting, and coagulation effect on ex vivo tissues, with a good linear correlation between the effect and the output energy.

A prospective study to evaluate the efficacy and adverse effects of alpha-blockers in the management of benign prostatic hyperplasia

Background: Benign prostatic hyperplasia (BPH) is the most common cause for the lower urinary tract symptoms in men. The conservative management of BPH comprises of alpha blockers, especially selective alpha 1 adrenergic blockers for symptomatic relief. Aims and Objectives: We aimed to evaluate the efficacy and adverse effects of alpha blockers in managing BPH. Materials and Methods: After getting approval from the Institutional Human Ethics Committee and consent from subjects, this prospective, randomized, and controlled trial was conducted. In this study, patients under inclusion criteria were divided into two groups. Group I received silodosin 8 mg once daily for 8 weeks. Group II received tamsulosin 0.4 mg once daily for 8 weeks. Primary outcome measure was reduction in international prostate symptom score (IPSS). Adverse events during study period were recorded. Results: A total of 90 patients were enrolled in this study. Ten patients were excluded and remaining 80 patients were divided as 40 in Group I (Silodosin) and 40 in Group II (Tamsulosin), patients were followed up for 8 weeks. As primary outcome, the IPSS at 8th week was significantly <0 week, that is, baseline in both the groups. The comparison of IPSS within Group I and Group II at 0 week and 8th week was significant (P < 0.05). The quality of life comparison within Group I and Group II at 0 week and 8th week was significant (P < 0.05). Both the drugs were well tolerated. Retrograde ejaculation and diarrhea were noted with silodosin (Group I), dizziness and orthostatic hypotension were noted with Tamsulosin (Group II). Conclusion: The obtained results showed that both silodosin and tamsulosin produced significant improvement in IPSS and quality of Life in BPH patients. In silodosin group, retrograde ejaculation and diarrhea were notable adverse effects and in tamsulosin group, dizziness and orthostatic hypotension were noted.

Innovation,thinking and prospect of benign prostatic hyperplasia surgery / 现代泌尿外科杂志

Benign prostatic hyperplasia (BPH) surgery has developed for more than 100 years. After several major revolutions, it is still constantly innovating, which in turn has profoundly affected people’s concept and strategy for treating BPH. This paper reviews the background and process of the evolution of BPH surgery, discusses the innovative methods and rules, and looks forward to the future developmental trend, in order to provide reference for the further development of BPH surgery.

Incidence rate and protection strategy of sexual dysfunction after minimally invasive surgery for benign prostatic hyperplasia / 现代泌尿外科杂志

In recent years, minimally invasive surgery has been rapidly developed and has become the first choice for the treatment of moderate to severe benign prostatic hyperplasia (BPH). Although it can significantly improve the lower urinary tract symptoms, reduce complications, and enhance security, postoperative sexual dysfunction(SD) is still common, which affects the patients’ quality of life. In this paper, we discuss the incidence rate of SD after BPH surgery, the protection strategy of sexual function, and how to choose reasonable treatment from the perspective of sexual function protection.

Achievement of satisfactory outcomes of benign prostatic hyperplasia surgery based on avoiding complications / 现代泌尿外科杂志

The outcomes of surgical treatment of benign prostatic hyperplasia (BPH) has been verified as it causes few complications. However, if complications develop, they will have significant impacts on patients’ quality of life. Therefore, in order to provide individualized treatments, patients’ general condition, expectations of treatment, clinical symptoms, prostate volume, advantages and disadvantages of different operative methods and operators’ mastery of operative methods should be considered to reduce the incidence of postoperative complications such as stress incontinence, urethral stricture and bladder neck contracture. This article discusses the choices of surgical interventions of BPH from the perspective of surgical safety and reduction of complications so as to improve the satisfaction of patients.

Experience and thinking of transurethral endoscopic surgery of benign prostatic hyperplasia / 现代泌尿外科杂志

The essence of the clinical problem caused by benign prostatic hyperplasia(BPH) is lower urinary tract obstruction. Compared with drug treatment, surgery can fundamentally relieve the obstruction. Transurethral endoscopic surgery has become the most important surgical treatment for BPH. In recent years, everyone has been working on exploring the physical properties of various energy platforms, especially lasers, to maximize their advantages in clinical use, various surgical concepts and methods contend. This article summarized my 40 years of experience in transurethral laparoscopic surgery to discuss my experience and thoughts.

450 nm diode blue laser vaporescetion of the prostate: a report after 100 BPH procedures / 现代泌尿外科杂志

【Objective】 To investigate the clinical efficacy and safety of transurethral blue laser vaporescetion of the prostate in the treatment of benign prostatic hyperplasia (BPH). 【Methods】 The clinical data of 100 BPH patients undergoing the surgery in our hospital during May and Sep.2022 were retrospectively analyzed. The observations included operation time, bladder irrigation duration, postoperative catheter indwelling time, hospital stay, complications, as well as changes in hemoglobin, International Prostate Symptom Score (IPSS), Quality of Life Scale (QoL) score, maximum urinary flow rate (Qmax), bladder residual urine volume (PVR), and other related indicators before and 3 months after surgery. 【Results】 All 100 procedures were successfully completed without turning to transurethral resection of the prostate and/or open surgery. No blood transfusion was needed. The operation time was (37.8±19.6) min, bladder irrigation time (1.3±0.5) d, catheter indwelling time (12.7±0.4) d, hospital stay (3.4±0.7) d, hemoglobin drop (4.1±7.1) g/L. The postoperative IPSS and QoL score were significantly lower than those before surgery (P<0.05); postoperative Qmax was higher than that before surgery (P<0.05); postoperative PVR was smaller than that before surgery (P<0.05). Urinary retention occurred in 4 cases (4%) after removal of the catheter; carnal hematuria and bladder clot formation occurred in 3 cases (3%); mixed urinary incontinence occurred in 2 cases (2%); stenosis of the external urethra occurred in 2 cases (2%). All complications were cured after symptomatic treatment. There were no serious perioperative complications, no intraoperative complications such as ureteral orifice injury or bladder perforation, and no serious postoperative complications such as transurethral resection syndrome (TURS), permanent urinary incontinence or bladder neck contracture. 【Conclusion】 The blue laser surgical system had satisfactory effects of vaporization and hemostasia. Transurethral blue laser vaporesection of the prostate is safe and effective in the treatment of BPH.

Clinical observation of blue laser in the treatment of benign prostatic hyperplasia / 现代泌尿外科杂志

【Objective】 To evaluate the clinical efficacy of 200 W blue laser vaporization of prostate and the possibility of developing such surgery into day surgery. 【Methods】 The clinical data of 30 patients treated during Aug. and Sep.2022 were retrospectively reviewed. The residual urine volume, urine flow rate, International Prostate Symptom Score (IPSS) and Quality of Life Scale(QoL) score before and after surgery were compared. The operation time and postoperative routine urinary red blood cell count were recorded. 【Results】 All surgeries were successful and the catheter was moved 1 day after surgery. The operation time was (12.2±5.1) min, postoperative bladder irrigation time (20.0±4.2) h, and urinary red blood cell count (806.2±16.3)/μL. Recatheter was needed in 1 patient. The urinary flow rate before surgery, immediately and 1-month after surgery were (10.6±3.5) mL/s, (24.2±5.6) mL/s, and (27.2±3.1) mL/s, respectively. The residual urine was (57.3±3.2) mL before surgery and (5.6±3.1) mL 1-month after surgery. The average preoperative IPSS and QoL scores were (25.1±1.6) and (5.4±0.7), and were (9.5±1.4) and (2.9±0.6), respectively, 3-months after surgery. 【Conclusion】 Transurethral 200 W blue laser vaporization of the prostate is a practical and feasible surgical technique for the treatment of benign prostatic hyperplasia. It is effective, rapid and safe, and can greatly shorten the length of hospital stay and improve perioperative safety. With the improvement of clinical application technology, it can be a choice of prostatic day surgery.

Comparison of the efficacy of transurethral columnar balloon dilation of prostate and transurethral bipolar plasmakinetic resection of prostate in the treatment of small volume (≤30 mL) benign prostatic hyperplasia / 现代泌尿外科杂志

【Objective】 To explore the efficacy of transurethral columnar balloon dilation of prostate (TUCBDP) and transurethral bipolar plasmakinetic resection of prostate (TUPKP) for patients with small volume (≤30 mL) benign prostatic hyperplasia (BPH) and the effects on urinary control and sexual function. 【Methods】 Clinical data of BPH patients who underwent surgical treatment during Jun.2021 and Jan.2022 were reviewed. A total of 95 patients with prostate volume ≤30 mL and regular sexual life were selected as subjects, including 45 patients who received TUCBDP as the TUCBDP group and 50 patients who received TUPKP as the TUPKP group. The patients were followed up for 12 months, and the perioperative data and follow-up results were analyzed. 【Results】 The TUCBDP group had shorter operation time, less intraoperative blood loss, less postoperative hemoglobin loss and sodium concentration loss, shorter bladder irrigation time, lower pain score, shorter urinary tube indwelling time and shorter hospital stay than the TUPKP group (P0.05). The TUPKP group had worse ejaculation function score and ejaculation disturbance score after surgery (P0.05), and the two indexes were superior in the TUCBDP group than in the TUPKP group. The TUCBDP group had significantly lower complication rate than the TUPKP group (P<0.05). 【Conclusion】 TUCBDP is safe and effective in the treatment of small volume (≤30 mL) BPH, less trauma, less biochemical interference, less pain, fewer complications, and shorter course of disease. It has little effect on the ejaculation function and erectile function, and is more suitable for patients requiring retention of sexual function. It has a good application prospect in the treatment of small volume BPH.

Efficacy of pelvic floor magnetic and electrical stimulation combined with Kegel exercise training in the treatment of stress urinary incontinence after minimally invasive surgery for benign prostatic hyperplasia / 现代泌尿外科杂志

【Objective】 To explore the clinical efficacy and safety of pelvic floor magnetic and electrical stimulation combined with Kegel exercise training in the treatment of stress urinary incontinence (SUI) after minimally invasive surgery for benign prostatic hyperplasia (BPH). 【Methods】 A total of 52 patients with SUI after minimally invasive surgery for BPH treated during Jan.2016 and Feb.2022 were randomly divided into test group (n=26) and control group (n=26). The test group received pelvic floor magnetic and electrical stimulation and Kegel exercise training, while the control group received Kegel exercise training only. The treatment lasted for 3 months. The scores of International Consultation on Incontinence Modular Questionnaire Short Form (ICIQ-SF), 1 h pad test, International Prostate Symptom Score (IPSS) and Incontinence Quality of Life Questionnaire (I-QoL) were recorded and compared between the two groups before and after treatment. The adverse reactions were observed. 【Results】 The scores of ICIQ-SF, IPSS and I-QoL and 1 h pad test significantly decreased in both groups after treatment (P0.05), but after treatment, the scores of ICIQ-SF,IPSS,I-QoL and 1 h pad test were significantly lower in the test group than in the control group (P<0.05). No severe adverse reactions were observed. 【Conclusion】 Pelvic floor magnetic stimulation combined with Kegel exercise training is safe and effective for SUI after minimally invasive surgery for BPH.

Effects of electrophysiological technique combined with pelvic floor muscle training on the rapid recovery of urinary incontinence after electroresection of prostatic hyperplasia / 现代泌尿外科杂志

【Objective】 To investigate the clinical effects of electrophysiological technique combined with pelvic floor muscle training on urinary incontinence after electroresection of benign prostatic hyperplasia (BPH) based on the concept of enhanced recovery after surgery (ERAS). 【Methods】 A total of 86 patients with urinary incontinence treated with electroresection of BPH during Oct.2019 and Feb.2022 were randomly divided into control group and observation group, with 43 cases in either group. All patients received health education plus pelvic floor muscle training, and the observation group also received electrophysiological treatment. The differences in the indexes before and after treatment were compared between the two groups. 【Results】 There were no significant differences in the 1 h pad test, ICIQ-SF score, maximum urinary flow rate (Qmax), post void residual (PVR), International Prostate Symptom Score (IPSS), 24 h urinary incontinence frequency, and Urinary Incontinence Quality of Life Questionnaire Score (I-QoL) before treatment between the two groups (P>0.05). However, after treatment, Qmax and I-QoL score were significantly higher in the observation group than in the control group, while the other 5 indicators were significantly lower in the observation group than in the control group (all P<0.05). The total clinical effective rate was significantly higher in the observation group than in the control group (P<0.05). 【Conclusion】 Electrophysiological technique combined with pelvic floor muscle training can effectively improve the symptoms of urinary incontinence and promote the recovery of urinary control function, which is in line with the concept of ERAS and is worthy of further research and promotion.

Efficacy of ThULEP versus HoLEP in treating benign prostatic hyperplasia: a Meta analysis / 现代泌尿外科杂志

【Objective】 To compare the efficacy and safety of thulium laser enucleation of the prostate (ThULEP) and holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH). 【Methods】 Randomized controlled trials (RCTs) and clinical controlled trials (CCTs) were searched in PubMed, Embase, Cochrane Library, CNKI and Wanfang Database from Jan.1,2010 to May 30,2022. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. All divergences were resolved by a third researcher. RevMan 5.4 software was used for Meta analysis. 【Results】 A total of 7 studies were included, involving 1 726 patients, 750 in the ThULEP group and 976 in the HoLEP group. Meta analysis showed that, compared with HoLEP group, the ThULEP group had shorter catheter indwelling time [MD=-0.10, 95%CI (-0.17--0.03), P=0.004] , shorter hospital stay [MD=-0.43, 95%CI (-0.60--0.25), P<0.000 01] , lower IPSS score 12 months after surgery [MD=-1.13, 95%CI (-1.95- -0.30), P=0.007] , lower QoL score 12 months after surgery [MD=-1.00, 95%CI (-1.19- -0.81), P<0.001] ,lower transfusion rate [OR=0.11, 95%CI (0.03-0.36), P=0.000 3] and lower incidence of urinary incontinence [OR=0.24, 95%CI (0.09-0.66), P=0.006] . 【Conclusion】 ThULEP may have similar efficacy and safety as HoLEP in the treatment of BPH, and has more advantages in some aspects.