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经尿道针刺消融术(TUNA)治疗良性前列腺增生(BPH)及再治疗率的36个月随访

[Treatment of benign prostatic hyperplasia (BPH) by transurethral needle ablation (TUNA) and 36-month follow-up of the retreatment rate].

作者信息

Martin Xavier, Claude Abbou, Colombel Marc, Sarramon Jean-Pierre, Ballanger Philippe, Lobel Bernard, Richard François, Saussine Christian, Cavillon Christophe, Buzelin Jean-Marie, Baron Jean-Christophe, Lambert Didier, Haillot Olivier

机构信息

Service d'Urologie, Hôpital Edouard Herriot, Lyon, France.

出版信息

Prog Urol. 2005 Sep;15(4):674-80.

Abstract

OBJECTIVE

Benign prostatic hyperplasia (BPH) is a disease affecting about 25% of men over the age of 40. One half of these men report symptoms that interfere with their daily activities.

MATERIAL AND METHODS

In this multicentre study, 102 patients with BPH were treated by transurethral needle ablation (TUNA). The efficacy of treatment was evaluated for 12 months after the operation by means of Madsen and IPSS (International Prostate Symptom Score) scores. The course of uroflowmetry and quality of life (International Score) and sexual function were also assessed for one year. The safety of treatment was evaluated according to the type and frequency of complications. The results show an immediate and significant improvement of symptoms (p < 0.0001 for Madsen and IPSS scores and maximum flow rate between M0 and M12) demonstrating the efficacy of the TUNA system. A very positive impact of TUNA was demonstrated on quality of life. No negative impact was reported on sexual function and the operation had very few repercussions with a low adverse event rate. The retreatment rate (surgical and/or drug) was evaluated 36 months after the operation by means of an optional follow-up questionnaire subsequently completed by the investigators.

RESULTS

After 3 years, based on the 80 questionnaires returned, 43 patients (53.8%) were stable and did not need any other medical or surgical treatment for BPH. Thirty-seven (37) patients (46.3%) required retreatment: 21 were treated with drugs (26%), 17 were treated surgically (21.25%) including 1 patient who was also retreated with drugs. This study demonstrates the significant and lasting improvement of BPH symptoms by TUNA, which constitutes an alternative attractive to surgery in young patients and/or patients worried about their sexuality.

摘要

目的

良性前列腺增生(BPH)是一种影响约25% 40岁以上男性的疾病。其中一半男性报告有干扰其日常活动的症状。

材料与方法

在这项多中心研究中,102例BPH患者接受了经尿道针刺消融术(TUNA)治疗。术后通过马德森评分和国际前列腺症状评分(IPSS)对治疗效果进行了12个月的评估。还对尿流率过程、生活质量(国际评分)和性功能进行了为期一年的评估。根据并发症的类型和发生率评估治疗的安全性。结果显示症状立即得到显著改善(马德森评分和IPSS评分以及M0和M12之间的最大尿流率p<0.0001),证明了TUNA系统的有效性。TUNA对生活质量有非常积极的影响。未报告对性功能有负面影响,手术的影响极小,不良事件发生率很低。术后36个月通过一份由研究者随后填写的可选随访问卷评估再治疗率(手术和/或药物)。

结果

3年后,根据80份返回的问卷,43例患者(53.8%)病情稳定,无需针对BPH进行任何其他药物或手术治疗。37例患者(46.3%)需要再治疗:21例接受药物治疗(26%),17例接受手术治疗(21.25%),其中1例患者同时也接受了药物再治疗。这项研究证明了TUNA能显著且持久地改善BPH症状,对于年轻患者和/或担心性功能的患者而言,TUNA是一种有吸引力的手术替代方案。

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