Alivizatos G, Ferakis N, Mitropoulos D, Skolarikos A, Livadas K, Kastriotis I
2nd Urology Department, Athens Medical School, Sismanoglion Hospital, Athens, Greece.
J Endourol. 2005 Jan-Feb;19(1):72-8. doi: 10.1089/end.2005.19.72.
To evaluate the effectiveness of the ProstaLund Compact Device in the treatment of benign prostatic hyperplasia (BPH).
A series of 38 consecutive patients with a mean age of 72.6+/-8.2 years, 19 with an indwelling catheter, underwent transurethral microwave thermotherapy (TUMT) with the ProstaLund Compact Device. Pretreatment evaluation included transrectal ultrasonography (TRUS), urodynamics, and cystoscopy for all patients and flow rate (Qmax), postvoiding residual urine volume (PVR), International Prostate Symptom Score (IPSS), and quality-of-life (QoL) assessment for those without a catheter. The mean prostate volume was 63.5+/-30 cc. The Qmax, IPSS, and QoL studies were repeated at 3, 6, and 12 months, while urodynamics, cystoscopy, and TRUS were repeated at 6 and 12 months.
The treatment lasted a mean of 43.1+/-17.1 minutes, achieved a maximal intraprostatic temperature of 58.7+/-7.2 degrees C, and destroyed 18.4+/-14.3 g of prostatic tissue. Twelve months post-treatment, for the patients without a catheter preoperatively, the IPSS was improved from 21.5+/-6.3 to 6.5+/-3.1 (P<0.001), Qmax from 7.2+/-3.1 mL/sec to 18.1+/-7.4 mL/sec (P<0.001), detrusor pressure at Qmax from 87.5+/-15 cm H2O to 48.4+/-16.4 cm H2O (P<0.001), and PVR from 113.2+/-78.2 mL to 34.6+/-36.7 mL (P<0.01). The good-response rates for IPSS (<or=7 or >or=50% improvement), Qmax (>or=15 mL/sec or >or=50% improvement), PVR (<50 mL or >or=50% decrease), and QoL (<or=2) were 73.7%, 84.2%, 73.7%, and 94.7%, respectively. For the patients with a catheter preoperatively, the IPSS improved from 9.5+/-6 at 3 months to 5.1+/-5.3 (P<0.05) at the end of the follow-up period. The Qmax was 13.2+/-6.4 mL/sec at 3 months and remained stable throughout the follow-up period. Patient good-response rates for IPSS (<or=7), PVR (<150 mL), and QoL (<or=2) were 75%, 87.5% and 75%, respectively. Only two patients were unable to void after the treatment. Complications were similar to those presented in the literature, and bladder stone formation was noted as well (five patients).
ProstaLund thermotherapy is a highly promising alternative treatment for BPH, improving substantially both objective and subjective measures of bladder outflow obstruction.
评估ProstaLund紧凑型设备治疗良性前列腺增生（BPH）的有效性。
连续38例平均年龄为72.6±8.2岁的患者，其中19例留置导尿管，接受了使用ProstaLund紧凑型设备的经尿道微波热疗（TUMT）。所有患者的术前评估包括经直肠超声检查（TRUS）、尿动力学检查和膀胱镜检查，未留置导尿管的患者还进行了最大尿流率（Qmax）、排尿后残余尿量（PVR）、国际前列腺症状评分（IPSS）及生活质量（QoL）评估。前列腺平均体积为63.5±30立方厘米。在3、6和12个月时重复进行Qmax、IPSS和QoL研究，在6和12个月时重复进行尿动力学检查、膀胱镜检查和TRUS。
治疗平均持续43.1±17.1分钟，前列腺内最高温度达到58.7±7.2摄氏度，破坏前列腺组织18.4±14.3克。治疗后12个月，术前未留置导尿管的患者，IPSS从21.5±6.3改善至6.5±3.1（P<0.001），Qmax从7.2±3.1毫升/秒提高至18.1±7.4毫升/秒（P<0.001），Qmax时逼尿肌压力从87.5±15厘米水柱降至48.4±16.4厘米水柱（P<0.001），PVR从113.2±78.2毫升降至34.6±36.7毫升（P<0.01）。IPSS（≤7或改善≥50%）、Qmax（≥15毫升/秒或改善≥50%）、PVR（<50毫升或降低≥50%）和QoL（≤2）的良好反应率分别为73.7%、84.2%、73.7%和94.7%。术前留置导尿管的患者，IPSS在3个月时为9.5±6，随访期末改善至5.1±5.3（P<0.05）。3个月时Qmax为13.2±6.4毫升/秒，随访期间保持稳定。IPSS（≤7）、PVR（<150毫升）和QoL（≤2）的患者良好反应率分别为75%、87.5%和75%。治疗后仅2例患者无法排尿。并发症与文献报道相似，还发现了膀胱结石形成（5例患者）。
ProstaLund热疗是一种极有前景的BPH替代治疗方法，能显著改善膀胱出口梗阻的客观和主观指标。
