Therapeutic effect of fluorescence-assisted laparoscopic Madigan on benign prostatic hyperplasia
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摘要: 目的:观察荧光辅助腹腔镜Madigan术对于良性前列腺增生(BPH)的疗效,评价其在保留尿道和术后正常射精功能中的价值。方法:28例BPH患者分成两组,14例行经尿道前列腺电切术(TURP)为对照组,14例行荧光辅助腹腔镜Madigan术为观察组。术后随访3个月,比较两组患者临床资料和术前、术后残余尿量(RUV)、最大尿流率(Qmax)、国际前列腺症状评分(IPSS)、生活质量评分(QOL)、男性性健康问卷-射精障碍评分(MSHQ-EJD)的差异。结果:两组患者年龄、BMI、前列腺体积、术前RUV、Qmax、IPSS评分、QOL评分、MSHQ-EJD评分比较差异无统计学意义,观察组手术时间长于对照组,术后膀胱冲洗时间及留置尿管时间少于对照组,差异有统计学意义(P<0.05)。两组患者术后RUV、IPSS评分比较差异无统计学意义,术后Qmax、QOL评分和MSHQ-EJD评分比较差异有统计学意义(P<0.05),观察组术后射精功能明显优于对照组。结论:荧光辅助腹腔镜Madigan术比TURP能更好地保护尿道完整性,改善患者术后射精功能障碍问题,提高患者生活质量,值得临床推广。Abstract: Objective: To observe the efficacy of fluorescence-assisted laparoscopic Madigan prostatectomy in the treatment of benign prostatic hyperplasia(BPH) and to evaluate its value in preservation of the prostatic urethra and ejaculation function. Method: Twenty-eight patients with BPH were divided into two groups. Fourteen patients in the control group were treated with transurethral resection of prostate(TURP), while other 14 patients in the observation group were treated with fluorescence-assisted laparoscopic Madigan prostatectomy. Patients in the two groups were followed up for 3 months,and the clinical data, preoperative and postoperative residual urine volume(RUV), maximum urine flow rate(Qmax), International Prostate Symptom Score(IPSS), quality of life score(QOL), and male sexual health questionnaire on EJD(MSHQ-EJD) were compared. Result: There was no significant difference in age, BMI, prostate volume, preoperative RUV, Qmax, IPSS, QOL score or MSHQ-EJD between the two groups. The operation time of the observation group was longer than that of the control group, but the duration of continuous bladder irrigation and indwelling catheter was shorter than that of the control group(P<0.05). There was no significant difference in postoperative RUV or IPSS between the two groups, but there was statistically significant difference in postoperative Qmax, QOL and MSHQ-EJD. Meanwhile, the ejaculation function of the observation group was significantly better than that of the control group.Conclusion: Compared with TURP, fluorescence-assisted laparoscopic Madigan prostatectomy can better protect the integrity of urethra and improve the ejaculation function and quality of life of patients, so it's worthy of clinical promotion.
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