{"title":"前列腺顶端尿道粘膜的预处理：预防前列腺铥激光去核术后压力性尿失禁的回顾性研究。","authors":"Yunfeng Liao, Yuting Wu, Junrong Zou, Ruohui Huang, Wei Xia, Yuanhu Yuan, Rihai Xiao, Xiaoning Wang, Gengqing Wu, Xiaofeng Zou, Guoxi Zhang","doi":"10.3389/fsurg.2024.1305006","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Explore the clinical application value of urethral mucosal pretreatment at the tip of the prostate in preventing stress urinary incontinence (SUI) after thulium laser enucleation of the prostate (ThuLEP).</p><p><strong>Methods: </strong>Eighty-seven patients with benign prostatic hyperplasia (BPH) treated with ThuLEP from June 2021 to December 2022 were divided into two groups. Of these, 42 patients (group A) underwent conventional ThuLEP and 45 patients (group B) were enucleated after pretreatment of the urethral mucosa. At the tip of the prostate, pretreatment of the urethral mucosa consisted of pushing the gland separately on both sides at the level of the verumontanum and cutting off the mucosa near the external urethral sphincter clockwise and counterclockwise. The perioperative and postoperative follow-up indicators [operation time, hemoglobin reduction, complications, Qmax, International Prostate Symptom Score (IPSS), quality of life (QoL), and post-void residual (PVR) volume] of the two groups of patients were collected and compared. All patients were followed up 1 month after surgery.</p><p><strong>Results: </strong>All 87 procedures were successfully completed. There was no significant difference in age and gland size between the two groups (<i>P</i> > 0.05). There was no significant difference between operating time and hemoglobin reduction in the two groups (<i>P</i> > 0.05). The Qmax, IPSS, QOL, and PVR volume were significantly improved postoperatively in both groups (<i>P</i> < 0.05). Temporary SUI occurred in both groups [12 cases (28.5%) in group A and 3 cases (6.7%) in group B (<i>P</i> < 0.05)]. There was no significant difference in the incidence of infection and urethral stricture between the two groups (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>Pretreatment of the urethral mucosa before ThuLEP for BPH significantly reduces the incidence of SUI after surgery. This technique, which preconditions the apical urethral mucosa of the prostate, is safe and effective, has few complications, and is worthy of clinical application.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11345196/pdf/","citationCount":"0","resultStr":"{\"title\":\"Pretreatment of the urethral mucosa at the tip of the prostate: a retrospective review in preventing stress urinary incontinence after thulium laser enucleation of the prostate.\",\"authors\":\"Yunfeng Liao, Yuting Wu, Junrong Zou, Ruohui Huang, Wei Xia, Yuanhu Yuan, Rihai Xiao, Xiaoning Wang, Gengqing Wu, Xiaofeng Zou, Guoxi Zhang\",\"doi\":\"10.3389/fsurg.2024.1305006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Explore the clinical application value of urethral mucosal pretreatment at the tip of the prostate in preventing stress urinary incontinence (SUI) after thulium laser enucleation of the prostate (ThuLEP).</p><p><strong>Methods: </strong>Eighty-seven patients with benign prostatic hyperplasia (BPH) treated with ThuLEP from June 2021 to December 2022 were divided into two groups. Of these, 42 patients (group A) underwent conventional ThuLEP and 45 patients (group B) were enucleated after pretreatment of the urethral mucosa. At the tip of the prostate, pretreatment of the urethral mucosa consisted of pushing the gland separately on both sides at the level of the verumontanum and cutting off the mucosa near the external urethral sphincter clockwise and counterclockwise. The perioperative and postoperative follow-up indicators [operation time, hemoglobin reduction, complications, Qmax, International Prostate Symptom Score (IPSS), quality of life (QoL), and post-void residual (PVR) volume] of the two groups of patients were collected and compared. All patients were followed up 1 month after surgery.</p><p><strong>Results: </strong>All 87 procedures were successfully completed. There was no significant difference in age and gland size between the two groups (<i>P</i> > 0.05). There was no significant difference between operating time and hemoglobin reduction in the two groups (<i>P</i> > 0.05). The Qmax, IPSS, QOL, and PVR volume were significantly improved postoperatively in both groups (<i>P</i> < 0.05). Temporary SUI occurred in both groups [12 cases (28.5%) in group A and 3 cases (6.7%) in group B (<i>P</i> < 0.05)]. There was no significant difference in the incidence of infection and urethral stricture between the two groups (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>Pretreatment of the urethral mucosa before ThuLEP for BPH significantly reduces the incidence of SUI after surgery. This technique, which preconditions the apical urethral mucosa of the prostate, is safe and effective, has few complications, and is worthy of clinical application.</p>\",\"PeriodicalId\":12564,\"journal\":{\"name\":\"Frontiers in Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-08-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11345196/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fsurg.2024.1305006\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fsurg.2024.1305006","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
Pretreatment of the urethral mucosa at the tip of the prostate: a retrospective review in preventing stress urinary incontinence after thulium laser enucleation of the prostate.
Objective: Explore the clinical application value of urethral mucosal pretreatment at the tip of the prostate in preventing stress urinary incontinence (SUI) after thulium laser enucleation of the prostate (ThuLEP).
Methods: Eighty-seven patients with benign prostatic hyperplasia (BPH) treated with ThuLEP from June 2021 to December 2022 were divided into two groups. Of these, 42 patients (group A) underwent conventional ThuLEP and 45 patients (group B) were enucleated after pretreatment of the urethral mucosa. At the tip of the prostate, pretreatment of the urethral mucosa consisted of pushing the gland separately on both sides at the level of the verumontanum and cutting off the mucosa near the external urethral sphincter clockwise and counterclockwise. The perioperative and postoperative follow-up indicators [operation time, hemoglobin reduction, complications, Qmax, International Prostate Symptom Score (IPSS), quality of life (QoL), and post-void residual (PVR) volume] of the two groups of patients were collected and compared. All patients were followed up 1 month after surgery.
Results: All 87 procedures were successfully completed. There was no significant difference in age and gland size between the two groups (P > 0.05). There was no significant difference between operating time and hemoglobin reduction in the two groups (P > 0.05). The Qmax, IPSS, QOL, and PVR volume were significantly improved postoperatively in both groups (P < 0.05). Temporary SUI occurred in both groups [12 cases (28.5%) in group A and 3 cases (6.7%) in group B (P < 0.05)]. There was no significant difference in the incidence of infection and urethral stricture between the two groups (P > 0.05).
Conclusion: Pretreatment of the urethral mucosa before ThuLEP for BPH significantly reduces the incidence of SUI after surgery. This technique, which preconditions the apical urethral mucosa of the prostate, is safe and effective, has few complications, and is worthy of clinical application.
期刊介绍：
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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