Chiang P o Hui, Chuang Yao Chi, Huang Chao Cheng, Chiang Chin Pei
Department of Urology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Urology. 2003 Apr;61(4):797-801. doi: 10.1016/s0090-4295(02)02514-1.
To evaluate the efficacy of a new approach for treatment of prostatic obstruction involving transperineal injection of dehydrated ethanol into the prostate using transrectal ultrasound (TRUS).
Dehydrated ethanol was injected transperineally into 11 patients with prostatic obstruction due to hyperplasia or carcinoma. Injections were performed under TRUS surveillance at bilateral sites of the prostate for an overall amount of 2 to 8 mL of ethanol for each patient.
There were no intraoperative complications, but postoperative urinary retention occurred in 1 patient who received catheterization for 3 days. The mean symptom score decreased from 17.7 +/- 6.0 (median 23) to 8.5 +/- 1.1 (median 3.5) at 3 months postoperatively (P < 0.01); mean peak urine flow rate increased from 5.3 +/- 4.0 mL/s (median 7) to 13.5 +/- 3.6 mL/s (median 14) (P < 0.05); and mean residual urine volume decreased from 231.9 +/- 209.8 mL (median 108) to 28.7 +/- 13.7 mL (median 34) (P < 0.01). There were no significant differences at 6 months when the same parameters were assessed. Pathologic findings for 2 patients with prostatic obstruction due to carcinoma showed only granulation tissue, with no evidence of malignancy in the treated area.
Our preliminary data suggest that this technique can be performed as an outpatient procedure. It is considered an alternative treatment for prostatic obstruction due to benign hyperplasia or carcinoma, especially when there is a high operative risk.
评估一种经直肠超声引导下经会阴向前列腺注射无水乙醇治疗前列腺梗阻的新方法的疗效。
对11例因增生或癌导致前列腺梗阻的患者经会阴注射无水乙醇。在经直肠超声监测下于前列腺双侧部位进行注射，每位患者注射总量为2至8毫升乙醇。
术中无并发症发生，但1例患者术后出现尿潴留，行导尿3天。术后3个月时，平均症状评分从17.7±6.0（中位数23）降至8.5±1.1（中位数3.5）（P<0.01）；平均最大尿流率从5.3±4.0毫升/秒（中位数7）增至13.5±3.6毫升/秒（中位数14）（P<0.05）；平均残余尿量从231.9±209.8毫升（中位数108）降至28.7±13.7毫升（中位数34）（P<0.01）。在6个月时评估相同参数，无显著差异。2例因癌导致前列腺梗阻患者的病理结果显示仅见肉芽组织，治疗区域无恶性证据。
我们的初步数据表明，该技术可作为门诊手术进行。它被认为是良性增生或癌所致前列腺梗阻的一种替代治疗方法，尤其是在手术风险较高时。
