1.Department of Urology, Institute of Urology, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
2.Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
3.Department of Urology, Tianjin Third Central Hospital Affiliated To Nankai University, Tianjin 300170, China
4.Department of Urology, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou 450003, China
5.Department of Urology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
6.Department of Urology, China-Japan Union Hospital of Jilin University, Changchun 130033, China
7.Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
8.Department of Urology, Qinghai University Affiliated Hospital, Xi’ning 810012, China
9.Department of Urology, People’s Hospital of Hainan Province, Hainan Affiliated Hospital of Hainan Medical University Haikou, Haikou 570311, China
10.Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
11.Department of Urology, General Hospital of Ningxia Medical University, Yinchuan 750003, China
12.Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
13.Department of Urology, Renmin Hospital of Wuhan University, Wuhan 430060, China
14.Department of Urology, the Second Hospital of Dalian Medical University, Dalian 116023, Liaoning, China
15.Department of Urology, Zhujiang Hospital of Southern Medical University, Guangzhou 510282, China
16.Department of Urology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
17.Department of Urology Surgery, Guizhou Province People’s Hospital, Guiyang 550002, China
18.Department of Urology, Xijing Hospital of Air Force Military Medical University, Xi’an 710032, China
19.Department of Urology, the 980th Hospital of the PLA Joint Logistics Support Force (Bethune International Peace Hospital of PLA), Shijiazhuang 050082, China
20.Department of Urology, Tangdu Hospital, the Air Force Military Medical University, Xi’an 710038, China
21.Department of Andrology, Jinling Hospital Affiliated to Nanjing University School of Medicine, Nanjing 210002, China
22.Department of Urology, Qilu Hospital of Shandong University, Jinan 250012, China
23.Department of Geriatrics, the Seventh Medical Center of Chinese, PLA General Hospital, Beijing 100027, China
24.Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
25.Department of Urology, People’s Hospital of Tibet Autonomous Region, Lhasa 850000, China
26.Department of Urology, South China Hospital, Shenzhen University, Shenzhen 518111, Guangdong, China
27.Department of Urology, the Second Xiangya Hospital of Central South University, Changsha 410011, China
28.Department of Urology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China
29.Department of Urology, Institute of Urology, Lanzhou University Second Hospital, Key Laboratory of Urological Diseases in Gansu Province, Lanzhou 730030, China
30.Department of Urology, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200011, China
31.Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 88 South Keyuan Road, Chengdu 610041, China
32.Department of Urology, the First People’s Hospital of Yunnan Province, Kunming University of Science and Technology, Kunming 650041, China
33.Department of Urology, the Fourth Hospital of Harbin Medical University, Heilongjiang Key Laboratory of Scientific Research in Urology, Harbin 150001, China
34.Department of Urology, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010059, China
35.Department of Urology, Huaihe Hospital of Henan University, Kaifeng 475000, Henan, China
36.Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
37.Department of Urology, Peking University First Hospital, the Institute of Urology, Peking University, National Urological Cancer Center, Beijing 100034, China
38.Department of Urology, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, Jiangxi, China
39.Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
40.Department of Urology, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
* xingnianzeng@126.com;
hedl@xjtu.edu.cn;
wangxinghuan1965@163.com
纸质出版:2022-10
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Clinical practice guideline for transurethral plasmakinetic resection of prostate for benign prostatic hyperplasia (2021 Edition)[J]. 解放军医学杂志(英文版), 2022,9(5):515-533.
Zeng XT, Jin YH, Liu TZ, Chen FM, Ding DG, Fu M, et al. Clinical practice guideline for transurethral plasmakinetic resection of prostate for benign prostatic hyperplasia (2021 Edition). Mil Med Res. 2022;9(1):14.
Clinical practice guideline for transurethral plasmakinetic resection of prostate for benign prostatic hyperplasia (2021 Edition)[J]. 解放军医学杂志(英文版), 2022,9(5):515-533. DOI: 10.1186/s40779-022-00371-6.
Zeng XT, Jin YH, Liu TZ, Chen FM, Ding DG, Fu M, et al. Clinical practice guideline for transurethral plasmakinetic resection of prostate for benign prostatic hyperplasia (2021 Edition). Mil Med Res. 2022;9(1):14. DOI: 10.1186/s40779-022-00371-6.
Benign prostatic hyperplasia (BPH) is highly prevalent among older men
impacting on their quality of life
sexual function
and genitourinary health
and has become an important global burden of disease. Transurethral plasmakinetic resection of prostate (TUPKP) is one of the foremost surgical procedures for the treatment of BPH. It has become well established in clinical practice with good efficacy and safety. In 2018
we issued the guideline "2018 Standard Edition" . However
much new direct evidence has now emerged and this may change some of previous recommendations. The time is ripe to develop new evidence-based guidelines
so we formed a working group of clinical experts and methodologists. The steering group members posed 31 questions relevant to the management of TUPKP for BPH covering the following areas: questions relevant to the perioperative period (preoperative
intraoperative
and postoperative) of TUPKP in the treatment of BPH
postoperative complications and the level of surgeons’ surgical skill. We searched the literature for direct evidence on the management of TUPKP for BPH
and assessed its certainty generated recommendations using the grade criteria by the European Association of Urology. Recommendations were either strong or weak
or in the form of an ungraded consensus-based statement. Finally
we issued 36 statements. Among them
23 carried strong recommendations
and 13 carried weak recommendations for the stated procedure. They covered questions relevant to the aforementioned three areas. The preoperative period for TUPKP in the treatment of BPH included indications and contraindications for TUPKP
precautions for preoperative preparation in patients with renal impairment and urinary tract infection due to urinary retention
and preoperative prophylactic use of antibiotics. Questions relevant to the intraoperative period incorporated surgical operation techniques and prevention and management of bladder explosion. The application to different populations incorporating the efficacy and safety of TUPKP in the treatment of normal volume (<80 ml) and large-volume (≥80 ml) BPH compared with transurethral urethral resection prostate
transurethral plasmakinetic enucleation of prostate and open prostatectomy; the efficacy and safety of TUPKP in high-risk populations and among people taking anticoagulant (antithrombotic) drugs. Questions relevant to the postoperative period incorporated the time and speed of flushing
the time indwelling catheters are needed
principles of postoperative therapeutic use of antibiotics
follow-up time and follow-up content. Questions related to complications incorporated types of complications and their incidence
postoperative leukocyturia
the treatment measures for the perforation and extravasation of the capsule
transurethral resection syndrome
postoperative bleeding
urinary catheter blockage
bladder spasm
overactive bladder
urinary incontinence
urethral stricture
rectal injury during surgery
postoperative erectile dysfunction and retrograde ejaculation. Final questions were related to surgeons’ skills when performing TUPKP for the treatment of BPH. We hope these recommendations can help support healthcare workers caring for patients having TUPKP for the treatment of BPH.
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