Abstract:
Abstract.
Introduction. Specialists are currently interested in the
method of choice for surgical treatment in patients with enlarged benign prostate hyperplasia (> 80 cm3
). The introduction of laser and bipolar technologies for benign prostate hyperplasia surgery has allowed effective treatment
regardless of the size of the prostate gland.
Material and methods. During 2020-2021, 65 patients
underwent surgical treatment for large benign prostate hyperplasia. Depending on the type of surgical treatment performed, 3 study groups were identified: 22 patients underwent transurethral Thulium: YAG laser prostate vapoenucleation; 21 patients underwent transurethral bipolar
prostate enucleation; and 21 patients underwent a simple
prostatectomy. All patients were examined before and after
surgery (at 3 and 6 months) using the International Prostate Symptom Score, Quality of Life Score, prostate-specific
antigen assessment, transrectal prostate ultrasound examination, and uroflowmetry to assess residual urine volume.
Postoperative complications were recorded in accordance
with the 2004 Clavien-Dindo classification.
Results. There was a significant difference in the mean
operative time ranging from 72±19 min (ThuVEP group)
vs. 56±10 min (SP group) and 70±15 min (TUEB group),
as well as a decrease in hemoglobin levels, viz. 1.2±0.4 g/dl
vs. 2.6±1.1 g/dl vs. 1.6±0.5 g/dl (ThuVEP vs. SP vs. TUEB).
The catheterization lasted for 2±1 days (ThuVEP) vs. 10±1
days (SP) vs. 3±1 days (TUEB). A significant improvement
in Qmax was registered in the ThuVEP group (122.9%) and
in the TUEB group (111.7%). However, patients after a simple prostatectomy showed an increase in Qmax of only 94%.
The PVR values were reported to be the same. ThuVEP is
an effective surgical technique for large BPH patients. The
reduced trauma and lower complication rate of ThuVEP, as
well as its effectiveness, have confirmed the need for widespread implementation of minimally invasive laser interventions.
