机构：[1]Department of Urology, Institute of Urology, Zhongnan Hospital of WuhanUniversity, Wuhan 430071, China[2]Center for Evidence‑Based and TranslationalMedicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China[3]Department of Urology, Tianjin Third Central Hospital Affiliated To NankaiUniversity, Tianjin 300170, China[4]Department of Urology, Henan ProvincialPeople’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou 450003,China[5]Department of Urology, Beijing Tsinghua Changgung Hospital, Schoolof Clinical Medicine, Tsinghua University, Beijing 102218, China[6]Departmentof Urology, China-Japan Union Hospital of Jilin University, Changchun 130033,China吉林大学中日联谊医院[7]Department of Urology, Shanghai General Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200080, China[8]Departmentof Urology, Qinghai University Affiliated Hospital, Xi’ning 810012, China[9]Department of Urology, People’s Hospital of Hainan Province, Hainan AffiliatedHospital of Hainan Medical University Haikou, Haikou 570311, China[10]Department of Urology, Sir Run Run Shaw Hospital, Zhejiang UniversitySchool 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 WuhanUniversity, Wuhan 430060, China[14]Department of Urology, The Second Hospitalof Dalian Medical University, Dalian 116023, Liaoning, China[15]Departmentof Urology, Zhujiang Hospital of Southern Medical University, Guangzhou510282, China[16]Department of Urology, Guangdong Provincial People’sHospital, 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 ForceMilitary Medical University, Xi’an 710032, China[19]Department of Urology, The980St Hospital of the PLA Joint Logistics Support Force (Bethune InternationalPeace 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 NanjingUniversity School of Medicine, Nanjing 210002, China[22]Department of Urology,Qilu Hospital of Shandong University, Jinan 250012, China[23]Departmentof Geriatrics, The Seventh Medical Center of Chinese, PLA GeneralHospital, Beijing 100027, China[24]Department of Urology, Beijing FriendshipHospital, Capital Medical University, Beijing 100050, China[25]Departmentof Urology, People’s Hospital of Tibet Autonomous Region, Lhasa 850000,China[26]Department of Urology, South China Hospital, Shenzhen University,Shenzhen 518111, Guangdong, China深圳市康宁医院深圳医学信息中心[27]Department of Urology, The SecondXiangya 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 Diseasesin Gansu Province, Lanzhou 730030, China[30]Department of Urology, Shanghai9Th People’s Hospital, Shanghai JiaoTong University School of Medicine,Shanghai 200011, China[31]Department of Urology, Institute of Urology, WestChina 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云南省第一人民医院[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 MongoliaMedical University, Hohhot 010059, China[35]Department of Urology, HuaiheHospital of Henan University, Kaifeng 475000, Henan, China[36]Departmentof Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Scienceand Technology, Wuhan 430030, China华中科技大学同济医学院附属同济医院[37]Department of Urology, PekingUniversity First Hospital, The Institute of Urology, Peking University, NationalUrological 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 ClinicalResearch Center for Cancer/Cancer Hospital, Chinese Academy of MedicalSciences and Peking Union Medical College, Beijing 100021, China[40]Departmentof Urology, The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061, China
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.
基金：
National Key Research and Development Plan of China [2016YFC0106300]; National Natural Science Foundation of ChinaNational Natural Science Foundation of China (NSFC) [82174230]; Major Program Fund of Technical Innovation Project of Department of Science and Technology of Hubei Province [2016ACAl52]
第一作者机构：[1]Department of Urology, Institute of Urology, Zhongnan Hospital of WuhanUniversity, Wuhan 430071, China[2]Center for Evidence‑Based and TranslationalMedicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
共同第一作者：
通讯作者：
通讯机构：[1]Department of Urology, Institute of Urology, Zhongnan Hospital of WuhanUniversity, Wuhan 430071, China[2]Center for Evidence‑Based and TranslationalMedicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
推荐引用方式(GB/T 7714)：
Xian‑Tao Zeng,Ying‑Hui Jin,Tong‑Zu Liu,et al.Clinical practice guideline for transurethral plasmakinetic resection of prostate for benign prostatic hyperplasia (2021 Edition)[J].MILITARY MEDICAL RESEARCH.2022,9(1):doi:10.1186/s40779-022-00371-6.
APA：
Xian‑Tao Zeng,Ying‑Hui Jin,Tong‑Zu Liu,Fang‑Ming Chen,De‑Gang Ding...&Xing‑Huan Wang.(2022).Clinical practice guideline for transurethral plasmakinetic resection of prostate for benign prostatic hyperplasia (2021 Edition).MILITARY MEDICAL RESEARCH,9,(1)
MLA：
Xian‑Tao Zeng,et al."Clinical practice guideline for transurethral plasmakinetic resection of prostate for benign prostatic hyperplasia (2021 Edition)".MILITARY MEDICAL RESEARCH 9..1(2022)
医学