O'Sullivan MartinJ, Murphy Colette, Deasy Conor, Iohom Gabrielle, Kiely Eamon A, Shorten George
Department of Urology, Cork University Hospital, Cork, Ireland.
J Am Coll Surg. 2004 Mar;198(3):394-403. doi: 10.1016/j.jamcollsurg.2003.10.016.
This article investigated the effects of transurethral resection of prostate on quality of life (QOL) and urinary symptoms in patients with benign prostatic hyperplasia (BPH).
In a prospective study, 30 patients without significant comorbidities undergoing transurethral resection of prostate for BPH were studied. Patients completed four validated questionnaires: the International Prostate Symptom Score and the associated QOL index because urinary symptoms, the Montgomery and Asberg Depression Rating Scale, the McGill Pain Questionnaire, and the QOL questionnaire Short Form-36. These were completed preoperatively, on the first postoperative day, on discharge from hospital, and at 1 and 3 months postoperatively.
The QOL of patients who undergo transurethral resection of prostate for BPH had significantly improved at 3 months after their operation. The International Prostate Symptom Score scores at 1 month (9.3+/-4.6) and 3 months (5.4+/-5.6) were less than they were preoperatively (19.9+/-7.1). The QOL index because urinary symptoms was less at 1 month (2.4+/-1.9) and at 3 months postoperatively (1.5+/-1.4) in comparison with the preoperative scores (4.5+/-1.2). The Montgomery and Asberg Depression Rating Scale scores at 1 month (5.4+/-6.8) and 3 months (4.9+/-6.5) were less than they were preoperatively (9.2+/-8.3). The McGill Pain Questionnaire sensory and pain rating index scores were less at 3 months than they were preoperatively (p=0.02 and p<0.02 respectively). The McGill Pain Questionnaire affective score was less at 1 month than it was preoperatively (p<0.03). The McGill Pain Questionnaire evaluative scores were less than the preoperative score at all times postoperatively. The role physical (p=0.007), bodily pain (p=0.006), social function (p=0.007), and physical component summary (p=0.007) subsections of the Short Form-36 were greater at 3 months postoperatively when compared with the preoperative scores.
Transurethral resection of prostate is associated with significant improvement in the overall QOL, in addition to urinary symptoms, of patients with BPH at 3 months postoperatively. The magnitude and timing of this improvement may serve as a useful comparator in determining the optimal treatment of patients with BPH.
本文研究了经尿道前列腺切除术对良性前列腺增生(BPH)患者生活质量(QOL)和泌尿系统症状的影响。
在一项前瞻性研究中,对30例无严重合并症且因BPH接受经尿道前列腺切除术的患者进行了研究。患者完成了四份经过验证的问卷:国际前列腺症状评分及相关的生活质量指数(用于评估泌尿系统症状)、蒙哥马利和阿斯伯格抑郁评定量表、麦吉尔疼痛问卷以及生活质量问卷简表36。这些问卷在术前、术后第1天、出院时以及术后1个月和3个月时完成。
因BPH接受经尿道前列腺切除术的患者在术后3个月时生活质量有显著改善。国际前列腺症状评分在术后1个月(9.3±4.6)和3个月(5.4±5.6)时低于术前(19.9±7.1)。与术前评分(4.5±1.2)相比,泌尿系统症状导致的生活质量指数在术后1个月(2.4±1.9)和3个月(1.5±1.4)时更低。蒙哥马利和阿斯伯格抑郁评定量表评分在术后1个月(5.4±6.8)和3个月(4.9±6.5)时低于术前(9.2±8.3)。麦吉尔疼痛问卷的感觉和疼痛评分指数在术后3个月时低于术前(分别为p = 0.02和p < 0.02)。麦吉尔疼痛问卷的情感评分在术后1个月时低于术前(p < 0.03)。麦吉尔疼痛问卷的评估评分在术后所有时间均低于术前评分。生活质量问卷简表36的角色功能(p = 0.007)、躯体疼痛(p = 0.006)、社会功能(p = 0.007)和生理健康总分(p = 0.007)子项在术后3个月时高于术前评分。
经尿道前列腺切除术与BPH患者术后3个月时总体生活质量以及泌尿系统症状的显著改善相关。这种改善的程度和时间可作为确定BPH患者最佳治疗方案的有用对照指标。