Comparison of the Therapeutic Effect of Transurethral Holmium Laser Enucleation in Patients with BPH after Transrectal or Transperineal Prostate Biopsy

Abstract

Abstract: Objective To observe and analyze the safety and effectiveness of transurethral holmium laser enucleation of the prostate (HoLEP) in patients with BPH after transrectal or transperineal prostate biopsy. Methods The data of 60 BPH patients who underwent HoLEP in the Department of Urology, First Affiliated Hospital of USTC(Anhui Provincial Hospital) from January 2018 to June 2020 were collected. All the patients are diagnosed by prostate biopsy and divided into transperineal group and transrectal group according to the operational approach.There were 29 cases in the transperineal group and 31 cases in the transrectal group. The basic information, perioperative indicators and follow-up data of 3 and 6 months after surgery were collected and analyzed. Results The length of surgery and postoperative catheterization time in the transrectal group was longer than that in the transperineal group, and the difference was statistically significant (P<0.05). The overall postoperative complication rate was lower in the transperineal group than in the transrectal groupthe transperineal group, the difference between the two groups was statistically significant (P<0.05). Comparison of the International Prostate Symptom Score (IPSS), Quality of Life Score (QOL) for prostate symptoms and maximal urinary flow rate (Qmax) of patients in the two groups at 3 and 6 months postoperatively, the difference was not statistically significant (P>0.05). Conclusion HoLEP treatment for BPH patients at 3 weeks after transperineal or transrectal prostate biopsy is effective and safe. In the patients who underwent HoLEP after transperineal biopsy, the operation time and indwelling catheterization time are shorter and has fewer complications postoperatively.

Key words: benign prostatic hyperplasia, transrectal prostate biopsy, transperineal prostate biopsy, transurethral holmium laser enucleation of the prostate

CLC Number:

R737

WANG Xuan-feng, WANG Xiong, GE Qing-yu, TAO Tao. Comparison of the Therapeutic Effect of Transurethral Holmium Laser Enucleation in Patients with BPH after Transrectal or Transperineal Prostate Biopsy[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(19): 4-7.

References

[1] MOBLEY D, FEIBUS A, BAUM N.Benign prostatic hyperplasia and urinary symptoms: Evaluation and treatment[J]. Postgraduate Medicine,2015,127(3):301-307.
[2] LITWIN M S, TAN H J.The Diagnosis and Treatment of Prostate Cancer: A Review[J]. The Journal of the American Medical Association,2017, 317(24):2532-2542.
[3] 施云峰,莫乃新,史红雷,等.经直肠前列腺穿刺后BPH患者行经尿道前列腺钬激光剜除术的疗效观察[J].中华男科学杂志,2019,25(5):403-407.
[4] 郭景阳,李红梅,马涛,等.经直肠超声引导经会阴前列腺穿刺活检与经直肠前列腺穿刺活检的临床效果对比分析[J].泌尿外科杂志(电子版),2021,13(1):17-21.
[5] ASSELDONK B V, BARKIN J, ELTERMAN D S.Medical therapy for benign prostatic hyperplasia: a review[J]. Canadian Journal of Urology,2015, 22(5S1):7-17.
[6] HONG J Y, YANG S C, AHN S, et al.Preoperative Comorbidities and Relationship of Comorbidities With Postoperative Complications in Patients Undergoing Transurethral Prostate Resection[J]. Journal of Urology,2011,185(4):1374-1378.
[7] GILLING P J, KENNET T K, DAS A K, et al.Holmium laser enucleation of the prostate(HoLEP) combined with transurethral tissue morcellation: an update on the early clinical experience[J]. J Endourol, 1998,12(5):457-459.
[8] 吕剑. 基于超声引导下经会阴前列腺穿刺活检与经直肠穿刺活检的安全性及准确性研究[J].中国社区医师,2020,36(34):16-17.
[9] PILATZ A, LÜDECKE G, WAGENLEHNER F.Infektionsprophylaxe bei der Prostatastanzbiopsie [Prophylaxis of infectious complications following prostate biopsy][J]. Urologe A,2017,56(6):759-763.
[10] 薛希芸,黄俊琳,赵云英.经尿道前列腺钬激光剜除术治疗伴有前列腺穿刺病史的BPH患者的效果分析[J].中外医学研究,2020,18(29):139-141.
[11] PARK B, CHOO S H, JEON H G, et al.Interval from prostate biopsy to radical prostatectomy does not affect immediate operative outcomes for open or minimally invasive approach[J]. J Korean Med Sci,2014,29(2):1688-1693.
[12] 王飞,徐耀宗.经会阴行前列腺穿刺活检的现状分析[J].国际泌尿系统杂志,2018,38(6):1034-1037.
[13] ROSENHAMMER B, SCHÖNHÄRL M, MAYR R, et al. Introduction of a New Score to Assess Surgical Efficiency in Holmium Laser Enucleation of the Prostate[J]. Urologia internationalis,2020,104(11-12):914-922.
[14] NOTTINGHAM C U, AGARWAL D K, VALADON C, et al.Correlating Patient Anxiety with Urinary Symptoms Before and After Holmium Laser Enucleation of the Prostate[J]. J Endourol,2020,34(7):782-787.
[15] CHEN J M, JIN T Y, XU X M.Research on influence of transurethral enucleation of the prostate on urethral function and sexual function of patients with benign prostatic hyperplasia[J]. Chin J Prev Cancer Treat,2015,22(11):183-184.
[16] CAMILLA G, ALESSANDRO N, PETER A, et al.safety of holmium laser enucleation of the prostate (holep) in patients with antithrombotic agents[J]. J Urol,2018,199(4):e838.