前立腺肥大症に対する腹膜外腹腔鏡手術と経尿道的切除術の比較：周術期成績と機能的回復に関する後向き比較分析
Xiangrong Ying1,2, Ke Gao1,2, Zibin Xu1,2
1Department of Urology, Shaoxing People's Hospital, 312000 Shaoxing, Zhejiang, China.
Background:
Benign prostatic hyperplasia (BPH) is highly prevalent in the aging male population. Transurethral resection of the prostate (TURP), the current gold standard treatment, demonstrates significant efficacy but is associated with complications and high retreatment rates. Extraperitoneal laparoscopic urethra-preserving prostatectomy has emerged as a promising minimally invasive surgical alternative. This study aimed to compare the efficacy and safety of modified extraperitoneal laparoscopic surgery with conventional TURP for BPH treatment.
Methods:
Ninety-two patients with BPH who underwent surgical treatment between May 2022 and July 2023 were included in this retrospective study and divided into two groups with 46 each: Transurethral resection of the prostate (TURP) group and extraperitoneal laparoscopic surgery (ELS) group. Preoperative International Prostate Symptom Score (IPSS), maximum urine flow rate (MFR), residual urine volume (RUV) and quality of life (QOL) scores were recorded and compared with those at the 3-month follow-up. Patient age, body mass index (BMI), prostate-specific antigen (PSA), prostate size and complications were also documented and compared between the groups.
Results:
Ninety-two patients were included in this study (46 in each group). Baseline characteristics were comparable between the groups. At 3 months, both groups demonstrated significant improvements in IPSS, MFR, RUV and QOL scores (p < 0.001). Compared with the TURP group, the ELS group showed greater improvements in IPSS, MFR, RUV and QOL scores, with fewer postoperative complications (p < 0.001).
Conclusions:
Extraperitoneal laparoscopic prostatectomy using the modified urethra-preserving technique was beneficial for restoring urinary continence and improving patients' quality of life. This approach showed favourable perioperative outcomes and low complication rates. Further studies with large sample sizes and extended follow-up periods are required to confirm these findings and determine the long-term efficacy of this strategy.
