Participants
Forty patients admitted to West China Fourth Hospital with the diagnosis of BPH between September 2022 and February 2023 were collected, 20 each treated with TURP and Rezūm. Perioperative data were collected from the patients and both groups were followed up after 1 year.
Inclusion criteria were as follows: Patients who underwent prostate ultrasound at our institution suggestive of increased volume; patients age > 45 years; IPSS score > 13; QOL score > 3;
Exclusion criteria were as follows: comorbidity with other urologic diseases; diseases of other organs; history of relevant surgical treatment; Patients with elevated PSA suspected of having prostate cancer;
Study Design
This study was a single-center, controlled clinical study. Patients in the two groups with no significant difference in general information were collected and followed up with an informed consent form and IPSS and QOL questionnaires.
TURP group: After general anesthesia, the patient was placed in the lithotomy position, and the plasma resectoscope was placed through the urethra. The patient's urethra, urethral opening, bladder internal and external sphincter, and prostate gland were observed in detail. Taking the verumontanum of the prostate as the distal starting point, a marker groove was cut out from the 6 o'clock position of the bladder neck, which was deep into the plane of the capsule. The left and right lobes and the collapsed gland at 12 o'clock of the neck were cut. The F22 triple-lumen catheter was indwelling and rinsed with 0. 9% sodium chloride solution. The catheter was removed depending on the patient's recovery.
Rezūm group: After satisfactory anesthesia, the patient was placed in the lithotomy position and disinfected. After local lubricating anesthesia with oxybuprocaine urethra, the operating mirror was placed. Hot steam ablation of the prostate was administered according to the patient's condition. Bladder irrigation and the mirror were withdrawn, the urinary catheter was left in place, and postoperative anti-inflammatory and hemostatic treatment was performed.
Outcome Measures
General information including age, BMI, tPSA(total prostate-specific antigen, normal value:0–4), fPSA(free prostate-specific antigen, normal value:0-0.75), fPSA/tPSA(normal value:0.15 ~ 0.48) drinking and smoking history, underlying disease, International prostatic symptom score (IPSS, mild prostatic hyperplasia:1-7score, moderate prostatic hyperplasia:8–19 score, severe prostatic hyperplasia:20–35 score) and quality of life 12 (QOL, Delighted: 0, Pleased: 1, mostly Satisfied: 2, Mixed about equally satisfied and dissatisfied: 3, Mostly dissatisfied: 4, Unhappy: 5, Terrible: 6) before treatment.
The primary index for effectiveness evaluation includes the perioperative period condition, and IPSS and QOL scores after 1 year. perioperative period condition includes operative time(minute), operative blood loss(ml), Numerical Rating Scale(NRS, No pain: 0 score, mild pain: 1–3 scores, moderate pain: 4–6 scores, severe pain: 7–10 scores;), hospital stay(day), duration of hematuria(day),extubating time(day).
Statistical analysis
All statistical analyses were performed using IBM SPSS Statistics27. Data were described by mean ± standard deviation(median), data obeying normality used the paired T-Test, and the data did not obey normality used the nonparametric test. Enumeration data were described by percentage(%), using the chi-square test for comparison. All statistical inferences were performed at a 2-sided significance level of P < 0.05.