Objective:The aim of this research was to evaluate the efficiency of reciprocating morcellation for removing giant benign prostatic hyperplasia during holmium laser enucleation of the prostate,investigate whether perf...Objective:The aim of this research was to evaluate the efficiency of reciprocating morcellation for removing giant benign prostatic hyperplasia during holmium laser enucleation of the prostate,investigate whether performing morcellation as a two-stage procedure improves tissue retrieval efficiency,and seek to determine the optimal interval between the two surgeries.Methods:This study included nine cases of holmium laser enucleation of the prostate with an enucleated prostate weight exceeding 200 g,indicative of substantial prostate enlargement.Morcellation was performed on Day 0(n=4),Day 4(n=1),Day 6(n=1),and Day 7(n=3).The intervals were compared regarding the morcellation efficiency,beach ball presence,and pathology.Results:The mean estimated prostate volume was 383(range 330e528)mL;the median enucleation weight was 252(interquartile range[IQR]222,342)g;and the median enucleation time was 83(IQR 62,100)min.The mean morcellation efficiency was 1.44(SD 0.55)g/min on Day 0 and 13.69(SD 2.46)g/min on day 7.The morcellation efficiency was 4.15 g/min and 10.50 g/min on Day 4 and Day 6,respectively,with significantly higher in the two-stage group compared to one-stage group(11.0 g/min vs.1.5 g/min;p=0.014).Efficiency was strongly correlated with intervals(p<0.001);the incidences of beach balls were 100%(4/4)and 60%(3/5)in the immediate and two-stage surgery groups,respectively.Conclusion:The efficiency of two-stage morcellation with reciprocating morcellators was highly related to the postoperative interval,with the maximum efficiency reached on Day 7.展开更多
BACKGROUND Primary prostate Burkitt's lymphoma is a rare and aggressive condition with a poor prognosis.Its clinical presentation can be challenging to differentiate from benign prostatic hyperplasia.Given the rar...BACKGROUND Primary prostate Burkitt's lymphoma is a rare and aggressive condition with a poor prognosis.Its clinical presentation can be challenging to differentiate from benign prostatic hyperplasia.Given the rarity of primary prostate Burkitt's lymphoma,its diagnosis and treatment remain unclear.CASE SUMMARY This report presents a case of a 57-year-old male with primary prostate Burkitt's lymphoma,initially misdiagnosed as prostatic hyperplasia.This case's operative process,intraoperative findings and postoperative management are discussed in detail.CONCLUSION Primary prostate lymphoma is difficult to distinguish from other prostate diseases.Holmium laser enucleation of the prostate(HoLEP),a minimally invasive procedure,is crucial in diagnosing and treating this rare disease.Clinicians should remain vigilant and thoroughly combine physical examination,imaging and test results when encountering patients of younger age with small prostate size but a rapid progression of lower urinary tract symptoms.HoLEP is an essential diagnostic and therapeutic tool in managing primary prostate Burkitt's lymphoma.展开更多
目的研究经尿道前列腺钬激光剜除术(holmium laser enucleation of the prostate,HoLEP)与经尿道双极等离子前列腺剜除术(transurethral bipolar plasma kinetic enucleation and resection of the prostate,PKERP)治疗前列腺增生的疗...目的研究经尿道前列腺钬激光剜除术(holmium laser enucleation of the prostate,HoLEP)与经尿道双极等离子前列腺剜除术(transurethral bipolar plasma kinetic enucleation and resection of the prostate,PKERP)治疗前列腺增生的疗效差异。方法选取2020年8月至2022年8月聊城市第二人民医院泌尿外科收治的前列腺增生患者90例,随机分为HoLEP组(45例,HoLEP治疗)、PKERP组(45例,PKERP治疗),比较两组围术期指标,测量术前、术后血清炎性因子、疼痛介质水平及最大尿流率,评估患者术后疼痛情况,统计术后并发症。结果HoLEP组术中出血量、膀胱冲洗天数、住院天数、导尿管留置天数均显著少于PKERP组;术后1周HoLEP组最大尿流率高于PKERP组;术后1天HoLEP组血清白介素-2(interleukin-2,IL-2)、白介素-6(interleukin-6,IL-6)均显著低于PKERP组(P<0.05);术后1天HoLEP组血清前列腺素E2(prostaglandin E2,PGE2)、5-羟色胺(5-hydroxy tryptamine,5-HT)水平显著低于PKERP组(P<0.05);术后1天、2天、3天HoLEP组疼痛视觉模拟评分法(visual analogue scale,VAS)均显著低于PKERP组,差异均有统计学意义(P<0.05);HoLEP组并发症发生率显著低于PKERP组(P<0.05)。结论HoLEP治疗前列腺增生,可显著下调患者术后炎性因子及疼痛介质水平,减轻患者术后疼痛感,且具有创伤性小、并发症少的优点。展开更多
文摘Objective:The aim of this research was to evaluate the efficiency of reciprocating morcellation for removing giant benign prostatic hyperplasia during holmium laser enucleation of the prostate,investigate whether performing morcellation as a two-stage procedure improves tissue retrieval efficiency,and seek to determine the optimal interval between the two surgeries.Methods:This study included nine cases of holmium laser enucleation of the prostate with an enucleated prostate weight exceeding 200 g,indicative of substantial prostate enlargement.Morcellation was performed on Day 0(n=4),Day 4(n=1),Day 6(n=1),and Day 7(n=3).The intervals were compared regarding the morcellation efficiency,beach ball presence,and pathology.Results:The mean estimated prostate volume was 383(range 330e528)mL;the median enucleation weight was 252(interquartile range[IQR]222,342)g;and the median enucleation time was 83(IQR 62,100)min.The mean morcellation efficiency was 1.44(SD 0.55)g/min on Day 0 and 13.69(SD 2.46)g/min on day 7.The morcellation efficiency was 4.15 g/min and 10.50 g/min on Day 4 and Day 6,respectively,with significantly higher in the two-stage group compared to one-stage group(11.0 g/min vs.1.5 g/min;p=0.014).Efficiency was strongly correlated with intervals(p<0.001);the incidences of beach balls were 100%(4/4)and 60%(3/5)in the immediate and two-stage surgery groups,respectively.Conclusion:The efficiency of two-stage morcellation with reciprocating morcellators was highly related to the postoperative interval,with the maximum efficiency reached on Day 7.
基金Supported by the Kunshan Research and Development Project,No.KSZ2203the Kunshan Research and Development Project,No.KZYY2205.
文摘BACKGROUND Primary prostate Burkitt's lymphoma is a rare and aggressive condition with a poor prognosis.Its clinical presentation can be challenging to differentiate from benign prostatic hyperplasia.Given the rarity of primary prostate Burkitt's lymphoma,its diagnosis and treatment remain unclear.CASE SUMMARY This report presents a case of a 57-year-old male with primary prostate Burkitt's lymphoma,initially misdiagnosed as prostatic hyperplasia.This case's operative process,intraoperative findings and postoperative management are discussed in detail.CONCLUSION Primary prostate lymphoma is difficult to distinguish from other prostate diseases.Holmium laser enucleation of the prostate(HoLEP),a minimally invasive procedure,is crucial in diagnosing and treating this rare disease.Clinicians should remain vigilant and thoroughly combine physical examination,imaging and test results when encountering patients of younger age with small prostate size but a rapid progression of lower urinary tract symptoms.HoLEP is an essential diagnostic and therapeutic tool in managing primary prostate Burkitt's lymphoma.
文摘目的研究经尿道前列腺钬激光剜除术(holmium laser enucleation of the prostate,HoLEP)与经尿道双极等离子前列腺剜除术(transurethral bipolar plasma kinetic enucleation and resection of the prostate,PKERP)治疗前列腺增生的疗效差异。方法选取2020年8月至2022年8月聊城市第二人民医院泌尿外科收治的前列腺增生患者90例,随机分为HoLEP组(45例,HoLEP治疗)、PKERP组(45例,PKERP治疗),比较两组围术期指标,测量术前、术后血清炎性因子、疼痛介质水平及最大尿流率,评估患者术后疼痛情况,统计术后并发症。结果HoLEP组术中出血量、膀胱冲洗天数、住院天数、导尿管留置天数均显著少于PKERP组;术后1周HoLEP组最大尿流率高于PKERP组;术后1天HoLEP组血清白介素-2(interleukin-2,IL-2)、白介素-6(interleukin-6,IL-6)均显著低于PKERP组(P<0.05);术后1天HoLEP组血清前列腺素E2(prostaglandin E2,PGE2)、5-羟色胺(5-hydroxy tryptamine,5-HT)水平显著低于PKERP组(P<0.05);术后1天、2天、3天HoLEP组疼痛视觉模拟评分法(visual analogue scale,VAS)均显著低于PKERP组,差异均有统计学意义(P<0.05);HoLEP组并发症发生率显著低于PKERP组(P<0.05)。结论HoLEP治疗前列腺增生,可显著下调患者术后炎性因子及疼痛介质水平,减轻患者术后疼痛感,且具有创伤性小、并发症少的优点。
