Chahal R, Sundaram S K, Gogoi N K
Department of Urology, Pinderfields and Pontefract NHS Trust, Wakefield, UK.
Urol Int. 2000;65(3):125-9. doi: 10.1159/000064856.
To assess the long-term outcome of patients undergoing KTP/YAG hybrid laser treatment for bladder outlet obstruction due to benign prostatic enlargement, in terms of symptomatic relief, complications, sexual function, patient satisfaction and acceptance of procedure.
The study recruited 148 patients prospectively. The hybrid laser treatment involved performing an initial bladder neck incision using KTP laser at 34 W followed by 4/6 point coagulation using NdYAG laser at 60 W. Patients were followed up till 2 years and assessed using uroflowmetry, International Prostate Symptom Score (IPSS), Patient Satisfaction Score (PSS), BPH impact index (BII) and the Danish Prostate Symptom Score (DAN-PSS) sexual function questionnaire.
137 patients were followed up for 2 years. There was a significant improvement in the maximum flow rate, IPSS and Quality of Life Scale (QLS). The mean BII (2.9) and the mean PSS (1.9) were low suggesting overall satisfaction with the procedure. The complications included urethral stricture (0.73%), bladder neck obstruction (2.15%) and retreatment (3.6%). 79.4% had a significant decrease in the ejaculate and 32.8% had a significant change in the strength of erections. On comparing the two groups (sexual function affected vs. not affected), the age, BII, IPSS and PSS were significantly higher (p < 0.05) in the group of patients that were affected.
Following KTP/YAG hybrid laser prostatectomy the outcome for voiding is good and durable for up to 2 years. The patient satisfaction level following the procedure is high and the procedure well accepted. However, significant interference with sexual function occurs, which appears to be occurring in tandem with a poor voiding outcome.
评估因良性前列腺增生导致膀胱出口梗阻而接受KTP/YAG混合激光治疗的患者的长期预后，包括症状缓解情况、并发症、性功能、患者满意度以及对手术的接受程度。
该研究前瞻性招募了148例患者。混合激光治疗包括先用34W的KTP激光进行初始膀胱颈切开术，然后用60W的NdYAG激光进行4/6点凝固术。对患者进行随访直至2年，并使用尿流率测定、国际前列腺症状评分（IPSS）、患者满意度评分（PSS）、良性前列腺增生影响指数（BII）以及丹麦前列腺症状评分（DAN-PSS）性功能问卷进行评估。
137例患者接受了2年的随访。最大尿流率、IPSS和生活质量量表（QLS）有显著改善。平均BII（2.9）和平均PSS（1.9）较低，表明对该手术总体满意。并发症包括尿道狭窄（0.73%）、膀胱颈梗阻（2.15%）和再次治疗（3.6%）。79.4%的患者射精量显著减少，32.8%的患者勃起强度有显著变化。比较两组（性功能受影响组与未受影响组），受影响患者组的年龄、BII、IPSS和PSS显著更高（p<0.05）。
KTP/YAG混合激光前列腺切除术后，排尿结果良好且可持续长达2年。术后患者满意度高，该手术易于接受。然而，性功能受到显著干扰，且似乎与排尿结果不佳同时出现。
