良性前列腺增生男性患者接受激光前列腺切除术与经尿道前列腺电切术的三年随访

Three-year follow-up of laser prostatectomy versus transurethral resection of the prostate in men with benign prostatic hyperplasia.

作者信息

Shingleton W Bruce, Farabaugh Paul, May Warren

机构信息

Division ofUrology, University of Mississippi School of Medicine, Jackson, Mississippi 39216, USA.

出版信息

Urology. 2002 Aug;60(2):305-8. doi: 10.1016/s0090-4295(02)01697-7.

DOI:10.1016/s0090-4295(02)01697-7

PMID:12137831

Abstract

OBJECTIVES

To present our 3-year data comparing laser prostatectomy and transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH). Laser prostatectomy was one of the first new minimally invasive treatment modalities for BPH, and few reports of the long-term results of this treatment regimen have been published.

METHODS

One hundred men with BPH in whom medical therapy had failed were randomized to undergo either laser prostatectomy or TURP. Preoperative measurements included American Urologic Association symptom score, prostate-specific antigen, uroflowmetry, and transrectal ultrasonography (TRUS). Laser prostatectomy was performed using the potassium titanyl-phosphate/neodynium:yttrium aluminum-garnet laser. TURP was performed in a standard manner with video monitoring. Patients were seen in follow-up at 1, 3, 6, and 12 months and every 12 months thereafter, with the following data obtained: symptom score, peak urinary flow rate, prostate-specific antigen level, and TRUS volume.

RESULTS

A total of 100 patients were entered into the study, with 50 patients in each treatment group. The mean age was 68.2 years (range 45 to 90) for the laser patients and 67.4 years (range 54 to 82) for the TURP group. The mean symptom score decreased from 22.0 to 9.9 at 36 months of follow-up for the laser patients compared with 21.2 to 7.7 for the TURP patients. The mean peak flow rate increased from 8.2 to 12.3 mL/s at 36 months for the laser group with a similar increase from 7.3 to 12.8 mL/s for the TURP patients. The mean TRUS volume for the laser patients decreased from 33.9 to 32.9 cm3 at 36 months compared with a mean TRUS volume of 29.6 cm3 preoperatively for the TURP patients that decreased to 26.3 cm3 at 36 months.

CONCLUSIONS

At 36 to 72 months of follow-up, the durability of results achieved by the patients in the laser cohort was similar to that for patients undergoing TURP.

摘要

目的

展示我们对比激光前列腺切除术和经尿道前列腺电切术（TURP）治疗良性前列腺增生（BPH）的3年数据。激光前列腺切除术是最早用于BPH的新型微创治疗方式之一，关于该治疗方案长期结果的报道较少。

方法

100例药物治疗失败的BPH男性患者被随机分为接受激光前列腺切除术或TURP。术前测量包括美国泌尿外科协会症状评分、前列腺特异性抗原、尿流率测定和经直肠超声检查（TRUS）。激光前列腺切除术使用磷酸钛钾/钕：钇铝石榴石激光进行。TURP采用标准方式并进行视频监测。患者在术后1、3、6和12个月以及此后每12个月进行随访，获取以下数据：症状评分、最大尿流率、前列腺特异性抗原水平和TRUS体积。

结果

共有100例患者纳入研究，每个治疗组50例。激光治疗组患者的平均年龄为68.2岁（范围45至90岁），TURP组为67.4岁（范围54至82岁）。随访36个月时，激光治疗组患者的平均症状评分从22.0降至9.9，而TURP组患者从21.2降至7.7。激光组最大尿流率在36个月时从8.2 mL/s增加到12.3 mL/s，TURP组患者从7.3 mL/s增加到12.8 mL/s。激光治疗组患者的TRUS平均体积在36个月时从33.9 cm³降至32.9 cm³，而TURP组患者术前TRUS平均体积为29.6 cm³，36个月时降至26.3 cm³。