Clinical application of directional dilation in transurethral columnar balloon dilation of the prostate

Objectives: To investigate the clinical efficacy and safety of directional dilation in transurethral columnar balloon dilation of the prostate (TUCBDP), and summarize relevant experience. Methods: Retrospective analysis was performed on the clinical data of 38 patients with prostatic hyperplasia admitted to the Department of Urology, The Second Hospital of Hebei Medical University from October 2017 to January 2020 who underwent TUCBDP with directional dilation (12 o'clock direction). Complications related to surgery including hemorrhage, urinary incontinence and pain were analyzed. Moreover, patients were followed up for six months postoperatively, and their preoperative and postoperative maximum urine flow rate (Qmax), residual bladder volume (PVR), international prostate symptom score (IPSS), and quality of life score (QoL) were compared. Results: Thirty-eight patients underwent TUCBDP successfully, with dilation positions all in the 12 o'clock direction and no ectopic dilation point. All patients had no severe hematuria postoperatively. Numeric rating scales (NRS) was utilized twice at 8h and 24hour postoperatively to score the pain degree, with no statistically significant difference (P=0.157). Hb was reexamined on the first day postoperatively, with no statistically significant difference compared with that preoperatively (P>0.05). The bladder irrigation time was 1-2 Day postoperatively, while the urethra was removed five days postoperatively, with no severe hematuria in all patients. Two patients developed mild urinary incontinence, which disappeared on the 2nd and 5th day after extubation, respectively, while no patients had dysuria and urinary retention. All 38 patients were detected for Qmax and PVR after urethral removal, with a statistically significant difference compared with those preoperatively (P<0.001), and were reexamined three months postoperatively for Qmax and PVR, with a statistically significant difference compared with those postoperatively (P<0.001); IPSS and QoL were significantly different from those preoperatively with statistically significance (P<0.001). At the follow-up six months postoperatively, Qmax, PVR and IPSS showed statistically significant differences compared with that at three months postoperatively (P<0.05), while QoL showed no statistically significant differences compared with that at 3 months postoperatively (P=0.088). Conclusion: Directional dilation is improved in TUCBDP as having the advantages of safety and effectiveness, and it is worthy of clinical promotion.