对于良性前列腺增生的患者，症状较轻的可以采取药物治疗。对于药物治疗无效、出现并发症，比如反复尿潴留、并发膀胱结石、血尿的患者，可以采取手术治疗。

随着科技的进展，目前绝大多数前列腺增生患者可以通过微创方式得到治疗。现在存在各种各样的微创治疗前列腺增生的方式。在这里，给大家科普一下各种方式的利弊。

经尿道前列腺电切术（TURP）,目前欧洲泌尿外科协会仍然把TURP作为治疗体积在30ml至80ml之间的前列腺增生的首选治疗方式。但是TURP存在一些并发症，比如电切综合征、有输血的可能性1,10年内10%~15%病人有可能需要接受二次治疗等等2。而这些并发症的发生比例随着病人前列腺体积增加而增加3。

等离子电切术同TURP相比较，止血效果较好，应用生理盐水作为灌注液4，发生电切综合征可能性较小。

激光汽化术，包括不同功率的绿激光前列腺汽化术，近期开展的蓝激光剜除术等。这些激光止血效果很好，安全性高5，可以获得和TURP相似的效果6, 7，但汽化术较难辨认外科包膜8，存在二期手术的可能性。另外，前列腺增生手术后有一部分病人会发现偶发性前列腺癌，汽化术因为没有组织送病理，会有一部分病人得不到正确的诊断。

经尿道前列腺剜除术（TUEP），包括钬激光前列腺剜除术9，铥激光前列腺剜除术10，等离子剜除术11，1470nm激光剜除术12, 13等等。剜除术同切除术的区别是（见示意图），剜除术首先沿着外科包膜将增生腺体分离出来，然后再通过不同的方式粉碎及取出前列腺增生腺体；而电切术是类似于用小勺挖苹果的方式，一点一点的将增生腺体从前列腺部尿道切到前列腺外科包膜。剜除术直接在外科包膜平面从血管根部止血，而切除术需要从尿道切到外科包膜才可以最终将出血的血管彻底止血；技术成熟的情况下，剜除术可以通过微创的方式达到开放手术的效果，同时出血少，并发症发生率低，术后症状改善程度优于TURP14。

还有最近国际上刚开展的UROLIFT等,目前国内开展的单位还不多，在国内还没有广泛开展。

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