Fu Wei-Jun, Hong Bao-Fa, Wang Xiao-Xiong, Yang Yong, Cai Wei, Gao Jiang-Ping, Chen Yao-Fu, Zhang Cui-E
Department of Urology, Chinese People's Liberation Army General Hospital, Military Postgraduate Medical College, No. 28 Fuxing Road, Hai dian District, Beijing 100853, China.
Asian J Androl. 2006 May;8(3):367-71. doi: 10.1111/j.1745-7262.2006.00134.x.
To explore the feasibility and safety of greenlight photoselective vaporization of the prostate (PVP) on high-risk patients presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH) and to evaluate their clinical and voiding outcome.
A total of 85 high-risk patients with obstructive BPH underwent PVP with an 80 W potassium-titanyl-phosphate laser, which was delivered through a side-deflecting fiber with a 23 Fr continuous flow cystoscope. Operative time, blood loss, indwelling catheterzation, international prostate symptom score (IPSS), quality of life score (QoL), uroflowmetry, postvoid residual urine volume and short-term complication rates were evaluated for all patients.
All patients got through the perioperative period safely. The chief advantages of PVP were: short operative time (25.6 +/- 7.6 min), little bleeding loss (56.8 +/- 14.3 mL) and short indwelling catheterization (1.6 +/- 0.8 d). The IPSS and QoL decreased from (29.6 +/- 5.4) and (5.4 +/- 0.6) to (9.5 +/- 2.6) and (1.3 +/- 0.6), respectively. The vast majority of patients were satisfied with voiding outcome. The mean maximal urinary flow rate increased to 17.8 mL/s and postvoid residual urine volume decreased to 55.6 mL. These results are significantly different from preoperative data (P < 0.05). No patient required blood transfusion or fluid absorption. There were few complications and very high patient satisfaction after operation.
PVP has a short operative time and high tolerance, and is safe, effective and minimally invasive for high-risk patients, therefore it might be considered as a good alternative treatment for high-risk patients with obstructive urinary symptoms as a result of BPH.
探讨绿激光选择性前列腺汽化术（PVP）应用于有下尿路症状提示良性前列腺增生（BPH）的高危患者的可行性和安全性，并评估其临床及排尿效果。
共85例高危梗阻性BPH患者接受了80W磷酸钛氧钾激光的PVP治疗，激光通过带有23Fr连续冲洗膀胱镜的侧射光纤传输。评估所有患者的手术时间、失血量、留置导尿情况、国际前列腺症状评分（IPSS）、生活质量评分（QoL）、尿流率、排尿后残余尿量及短期并发症发生率。
所有患者均安全度过围手术期。PVP的主要优点为：手术时间短（25.6±7.6分钟）、失血量少（56.8±14.3毫升）及留置导尿时间短（1.6±0.8天）。IPSS和QoL分别从（29.6±5.4）和（5.4±0.6）降至（9.5±2.6）和（1.3±0.6）。绝大多数患者对排尿效果满意。平均最大尿流率增至17.8毫升/秒，排尿后残余尿量降至55.6毫升。这些结果与术前数据有显著差异（P<0.05）。无患者需要输血或液体吸收。术后并发症少，患者满意度高。
PVP手术时间短、耐受性高，对高危患者安全、有效且微创，因此可被视为BPH所致梗阻性尿路症状高危患者的一种良好替代治疗方法。
