当代一系列患者开放性经膀胱前列腺切除术的长期结果。

Long-term results of open transvesical prostatectomy from a contemporary series of patients.

作者信息

Varkarakis Ioannis, Kyriakakis Zacharias, Delis Athanasios, Protogerou Vasilios, Deliveliotis Charalambos

机构信息

Second Department of Urology, Sismanoglio Hospital, University of Athens, Athens, Greece.

出版信息

Urology. 2004 Aug;64(2):306-10. doi: 10.1016/j.urology.2004.03.033.

DOI:10.1016/j.urology.2004.03.033

PMID:15302484

Abstract

OBJECTIVES

To provide information about the long-term efficacy of transvesical prostatectomy from a contemporary series of patients. When comparing minimally invasive procedures with open prostatectomy, the data for the latter are usually provided from old studies or from recent ones performed in developing countries. However, this procedure is still used frequently for large-size prostates.

METHODS

During a 5-year period, 232 patients with large (greater than 75 g) prostates underwent open transvesical prostatectomy for symptomatic benign prostatic hyperplasia. Patient charts were retrospectively reviewed for preoperative and postoperative International Prostate Symptom Scores, postvoid residual urine volumes, maximal flow rates, early and late postoperative complications, and the need for reoperation. The preoperative International Prostate Symptom Score, postvoid residual urine volume, and maximal flow rate were compared with the corresponding postoperative data at 8 to 12 months and at the last follow-up visit.

RESULTS

Complete data evaluation was possible for 151 patients, with a mean follow-up of 41.8 +/- 15.6 months. Improvement in International Prostate Symptom Score, postvoid residual urine volume, and maximal flow rate was statistically significant (P <0.001) at 8 to 12 months and remained statistically significant at the last follow-up visit. Long-term complications included bladder neck contraction in 5 (3.3%) occurring at a mean of 10 months (range 5 to 17), urethral strictures in 1 (0.6%), and meatal stenosis in 2 (1.3%) of 151 patients. Re-operation was required in 6 patients (3.9%).

CONCLUSIONS

Transvesical prostatectomy in a contemporary series of patients proved to be successful, with a low rate of complications. Its success has a durable effect and only rarely was a corrective procedure necessary. This approach should be included in the list of possible treatments to discuss with the patient with a large prostate.

摘要

目的

通过一组当代患者提供经膀胱前列腺切除术的长期疗效信息。在将微创手术与开放性前列腺切除术进行比较时，后者的数据通常来自旧研究或在发展中国家进行的近期研究。然而，该手术仍经常用于治疗大体积前列腺。

方法

在5年期间，232例大体积（大于75g）前列腺患者因有症状的良性前列腺增生接受了开放性经膀胱前列腺切除术。对患者病历进行回顾性分析，以获取术前和术后的国际前列腺症状评分、排尿后残余尿量、最大尿流率、术后早期和晚期并发症以及再次手术的必要性。将术前国际前列腺症状评分、排尿后残余尿量和最大尿流率与术后8至12个月及最后一次随访时的相应数据进行比较。

结果

151例患者可进行完整的数据评估，平均随访时间为41.8±15.6个月。国际前列腺症状评分、排尿后残余尿量和最大尿流率在术后8至12个月有统计学显著改善（P<0.001），在最后一次随访时仍有统计学显著意义。长期并发症包括151例患者中有5例（3.3%）发生膀胱颈挛缩，平均发生时间为10个月（范围5至17个月），1例（0.6%）发生尿道狭窄，2例（1.3%）发生尿道口狭窄。6例患者（3.9%）需要再次手术。