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EVALUATION OF RESULTS EARLY SURGERY TO REMOVE BENIGN PROSTATIC HYPERTROPHY BY HOLMIUM LASER THROUGH URETHRAL ENDOSCOPY AT VIETNAM – GERMANY FRIENDSHIP HOSPITAL
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Abstract
Objectives:In this study, we apply the technique of enucleation modified en block of benign prostate hyperplasia by Holmium laser and evaluate the early results of this surgery. Materials and Methods: We evaluated on 38 patients with urinary disorders due to benign prostatic hyperplasia, undergoing surgery to remove hypertrophic benign prostate by Holmium laser from april 2020 to August 2020. The en bloc method enucleation modified was performed by 2 incisions at 12 o'clock and 6 o'clock.Perioperative we assessed the time of enucleation, the time of morcellation to take the specimens out. The amount of blood lost during surgery, bleeding complications. Postoperative parameters include: time of urethral catheterization, length of hospital stay. Functional outcomes: Qmax and IPSS at 3 month postoperative. Short term complications including clot retention (blood clot retention in the bladder), blood transfusion, urinary tract infection, recatheterisation, and incontinence.Clavien–Dindo classification complications, and continence status were assessed. Patients were assessed for follow-up after surgery for 3 month. Result: The average age is 73.7 ± 10.4. 100 percents of patients was admitted to the hospital with a severe IPSS score of ≥ 20 points and 84.2 percents of patients had miserable and intolerable quality of life with a QoL score ≥ 5 points. The average size of PBH measured on ultrasound was 75.97 ± 27.65 ml. The average surgery time was 96.84 ± 11.47. The mean removal time was 66.21 ± 10.81. The difference in HGB before and after surgery was not significant (1.09 ± 0.78 g/dL), however, the highest postoperative complication was blood transfusion after surgery with 10.5%. Most of these cases had low preoperative HGB level. The international score of prostate symptoms (IPSS) mean improvement after surgery 1, 3, 6 months reduced from 28.95 to 6.16, 4.39, 3.61, respectively. 100% of patients rated the quality of life after 6 months of surgery as good with an average QoL score of 1.24. Conclusion: The procedure of enucleation of benign prostatic hyperplasia with Holmium laser is safe and effective surgery for all sizes of benign prostatic hyperplasia.
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Keywords
benign prostatic hyperplasia, holmium laser, enucleation
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