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尿动力学梗阻男性与经选择的尿动力学无梗阻或不明确男性经尿道前列腺切除术的结果比较。

Comparison of outcomes of transurethral prostate resection in urodynamicallyobstructed versus selected urodynamicallyunobstructed or equivocal men.

作者信息

van Venrooij Ger E P M, van Melick Harm H E, Boon Tom A

机构信息

Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands.

出版信息

Urology. 2003 Oct;62(4):672-6. doi: 10.1016/s0090-4295(03)00511-9.

Abstract

OBJECTIVES

To compare the benefits of transurethral resection of the prostate in urodynamically obstructed versus selected urodynamically unobstructed or equivocal men with severe lower urinary tract symptoms associated with benign prostatic enlargement.

METHODS

In this case series study, men with lower urinary tract symptoms were selected if they met the study criteria and underwent the tests recommended by the International Scientific Committee on Benign Prostatic Hyperplasia. They also underwent urodynamic investigations. Men were included when transurethral resection of the prostate was selected as the treatment modality. Of the 132 included subjects, 93 could be re-evaluated 6 months after surgery.

RESULTS

Of the 93 re-evaluated men, 59 were obstructed and 34 were unobstructed or equivocal. Both groups were similar with respect to age, symptoms, bother, benign prostatic hyperplasia-impact index, and quality of life. The quantified reductions in symptoms and bother in the unobstructed and equivocal men were about 70% of those reductions in the obstructed men. In the equivocal men, and even in the unobstructed men, a significant reduction with 40% of the urethral resistance occurred.

CONCLUSIONS

Transurethral resection of the prostate may be a good treatment alternative for unobstructed or equivocal men with severe lower urinary tract symptoms associated with prostatic enlargement, who opt for resection or who do not respond to or do not tolerate medical therapy.

摘要

目的

比较经尿道前列腺切除术对存在尿动力学梗阻的男性与部分存在或可疑存在尿动力学无梗阻但有严重下尿路症状且伴有良性前列腺增生的男性的益处。

方法

在本病例系列研究中,选择符合研究标准且接受了国际良性前列腺增生科学委员会推荐检查的下尿路症状男性。他们还接受了尿动力学检查。当选择经尿道前列腺切除术作为治疗方式时纳入研究对象。在纳入的132名受试者中,93名在术后6个月可进行重新评估。

结果

在93名接受重新评估的男性中,59名存在梗阻,34名无梗阻或可疑存在梗阻。两组在年龄、症状、困扰程度、良性前列腺增生影响指数和生活质量方面相似。无梗阻和可疑存在梗阻的男性在症状和困扰程度方面的量化减轻约为存在梗阻男性减轻程度的70%。在可疑存在梗阻的男性中,甚至在无梗阻的男性中,尿道阻力显著降低了40%。

结论

对于存在严重下尿路症状且伴有前列腺增生、选择手术切除或对药物治疗无反应或不耐受的无梗阻或可疑存在梗阻的男性,经尿道前列腺切除术可能是一种不错的治疗选择。

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