Apical breakthrough enucleation with lobar resection for the treatment of large-volume benign prostatic hyperplasia
LIU Zhaofei
ZHANG Haitao
OUYANG Jun
XU Xiangjun
MAO Pengfei
WANG Fei
HUANG Yongbin
WANG Heng
Abstract：Objective To explore the safety and efficacy of apical breakthrough enucleation with lobar resection in the treatment of large-volume benign prostatic hyperplasia(BPH).Methods A retrospective analysis was conducted on 90 BPH pa-tients with prostate volume＞80 mL admitted to the Urology Department of Lianyungang Affiliated Hospital of Nanjing University of Chinese Medicine from March 2021 to March 2025.The patients in control group(43 cases)underwent conventional transurethral plasmakinetic resection of the prostate(PKRP).And in the observation group(47cases),apical breakthrough enucleation with lo-bar resection was performed.The surgical outcomes(operation time,intraoperative blood loss,resected prostate weight),postopera-tive recovery(indwelling catheter duration,bladder residual urine volume[BVR],maximum urinary flow rate[Qmax]),postopera-tive complications(infection,massive hemorrhage,stress urinary incontinen[SUI]),and International Prostate Symptom Score(IPSS)were compared between the two groups.Results There was no statistically significant difference in operation time between the two groups(P＞0.05).The observation group showed better results in intraoperative blood loss([12.26±4.18]g/L vs[15.53±4.22]g/L)and indwelling catheter duration([3.66±0.87]d vs[5.63±0.69]d)compared to the control group(P＜0.01).The resected prostate tissue volume in the observation group was significantly larger than that in the control group([47.06±4.32]g vs[40.76±5.99]g,P＜0.01).There was no statistically significant difference in the incidence of SUI between the two groups(10.64％vs 6.98％,P＞0.05).After 6 months of postoperative follow-up,there was no significant difference in IPSS and BVR between the two groups(P＞0.05),but the Qmax in the observation group was significantly higher than that in the control group([22.23±2.42]mL/s vs[20.33±2.12]mL/s,P＜0.01).Conclusion Compared with PKRP,apical breakthrough enucleation with lobar resection is equal-ly safe but more effective in the treatment of large-volume BPH,making it an ideal therapeutic option.
Keywords：benign prostatic hyperplasiaplasmakinetic resection of the prostatelobar enucleationcomplicationsther-apeutic efficacy
Publication Date：2025-12-20
Online Publishing Date：2026-01-22(First online date of this platform, not the publication date of the document)
Pages：5( 1082-1086 )