Kojima M, Hayakawa T, Saito T, Mitsuya H, Hayase Y
Nagoya Urology Hospital.
Nihon Hinyokika Gakkai Zasshi. 2001 May;92(4):513-9. doi: 10.5980/jpnjurol1989.92.513.
To characterize age-related clinical and urodynamic features of patients with benign prostatic hyperplasia (BPH) treated by transurethral resection of the prostate (TUR-P).
Between July 1994 and March 2000, a total number of 451 patients underwent TUR-P in Nagoya Urology Hospital. Out of these 451 patients, 15 (3.3%) were diagnosed as having an incidental prostate cancer on pathological examination of resected prostate tissue. The remaining 436 patients (48-92 years, 69.8 +/- 7.4 years), in whom 196 (45.0%), 208 (47.7%) and 32 (7.3%) were < or = 69, 70-79 and > or = 80 years, respectively, were subjects for the present study. Their clinical features before and after TUR-P and the therapeutic effects of the treatment were evaluated in terms of aging.
Among preoperative variables evaluated, IPSS in patients aged < or = 69 years was significantly higher than in those aged 70-79 years (p < 0.05). The QOL index was significantly higher in patients aged > or = 80 years than in those aged 70-79 years (p < 0.05). The maximum bladder capacity decreased with age from 276 ml in patients aged < or = 69 years to 211 ml in those aged > or = 80 years. Postoperatively, both maximum and mean flow rates were significantly lower in patients aged 70-79 and > or = 80 years compared to those aged < or = 69 years. There was, however, no significant age-related difference in IPSS and QOL index. The assessment of treatment effects at 3 months following TUR-P revealed that the outcomes in function as evaluated by uroflowmetry, anatomy and ultrasonic measurement of prostate volume were significantly worse in patients aged > or = 80 years compared to those in younger patients. However, there was no significant age-related difference in outcomes in subjective symptoms and QOL.
TUR-P could be performed safely even in patients aged > or = 80 years. It is concluded that although postoperative urinary condition might be worse in older patients, they would nevertheless be satisfied with the results of TUR-P in the same way as less aged patients. As long as subjects are selected properly based on the correct diagnosis of BPH and a sufficient evaluation of operation risks, TUR-P can be expected to be performed safely and be followed by satisfaction with the treatment effects.
描述经尿道前列腺切除术（TUR-P）治疗的良性前列腺增生（BPH）患者的年龄相关临床和尿动力学特征。
1994年7月至2000年3月期间，名古屋泌尿外科医院共有451例患者接受了TUR-P手术。在这451例患者中，15例（3.3%）在切除的前列腺组织病理检查中被诊断为偶发前列腺癌。其余436例患者（年龄48 - 92岁，平均69.8±7.4岁），其中196例（45.0%）年龄≤69岁，208例（47.7%）年龄在70 - 79岁，32例（7.3%）年龄≥80岁，作为本研究的对象。根据年龄对他们TUR-P前后的临床特征及治疗效果进行评估。
在评估的术前变量中，年龄≤69岁患者的国际前列腺症状评分（IPSS）显著高于70 - 79岁患者（p < 0.05）。生活质量（QOL）指数在年龄≥80岁患者中显著高于70 - 79岁患者（p < 0.05）。最大膀胱容量随年龄增长而降低，从年龄≤69岁患者的276 ml降至年龄≥80岁患者的211 ml。术后，70 - 79岁和≥80岁患者的最大尿流率和平均尿流率均显著低于年龄≤69岁的患者。然而，IPSS和QOL指数在年龄方面无显著差异。TUR-P术后3个月的治疗效果评估显示，与年轻患者相比，年龄≥80岁患者通过尿流率测定、解剖学及前列腺体积超声测量评估的功能结局显著更差。然而，主观症状和QOL的结局在年龄方面无显著差异。
即使是年龄≥80岁的患者，TUR-P也可安全进行。得出的结论是，尽管老年患者术后排尿情况可能较差，但他们对TUR-P结果的满意度与年轻患者相同。只要基于BPH的正确诊断和对手术风险的充分评估正确选择患者，TUR-P有望安全进行并使患者对治疗效果满意。
