双极经尿道前列腺切除术：临床及尿动力学评估

Bipolar transurethral resection of prostate: clinical and urodynamic evaluation.

作者信息

Iori Francesco, Franco Giorgio, Leonardo Costantino, Laurenti Cesare, Tubaro Andrea, D-Amico Francesco, Dini Danilo, De Nunzio Cosimo

机构信息

Department of Urology, University of Rome La Sapienza, Rome, Italy.

出版信息

Urology. 2008 Feb;71(2):252-5. doi: 10.1016/j.urology.2007.09.064.

DOI:10.1016/j.urology.2007.09.064

PMID:18308095

Abstract

OBJECTIVES

To report our experience with the clinical effectiveness of endoscopic resection of the prostate using the bipolar Gyrus PlasmaKinetic System.

METHODS

A total of 120 patients with lower urinary tract symptoms were observed from 2002 to 2005. Of these 120 patients, 90 developed benign prostatic hyperplasia and were considered to have obstruction, and 51 of these 90 were scheduled for prostate surgery. The patients were randomized 1:1, using envelopes, into two groups: bipolar transurethral resection of the prostate (TURP) using the Gyrus PlasmaKinetic System (PK group) and monopolar TURP (standard TURP group). All patients were evaluated at baseline and follow-up (12 months after treatment) by medical history, International Prostate Symptom Score, inclusive of the question on quality of life, and physical examination, including digital rectal examination, transrectal ultrasonography, and pressure flow study. Statistical analysis was applied on the change in International Prostate Symptom Score and urodynamic parameters comparing the endpoints with baseline and comparing the baseline and follow-up characteristics between the two groups.

RESULTS

The mean resection time was 39.1 minutes and 31.7 minutes for the PK and standard TURP groups, respectively (P = 0.437). The mean postoperative hemoglobin reduction at 24 hours of follow-up was 1.25 g/dL, with a 2.1% hematocrit reduction, in the PK group and 1.81 g/dL, with a 3.2% hematocrit reduction, in the standard TURP group (P = 0.716). Improvements in flow rate, International Prostate Symptom Score, quality-of-life score, and bladder outlet obstruction grade were comparable between the two groups.

CONCLUSIONS

Bipolar TURP using the bipolar Gyrus PlasmaKinetic System seems to be a safe and effective procedure that is potentially associated with fewer side effects and could result in this procedure being more attractive for high-risk patients or, as recently proposed, for training purposes.

摘要

目的

报告我们使用双极Gyrus等离子体动力系统进行前列腺内镜切除术的临床疗效经验。

方法

2002年至2005年共观察了120例下尿路症状患者。在这120例患者中，90例患有良性前列腺增生并被认为存在梗阻，其中51例计划进行前列腺手术。使用信封将患者按1:1随机分为两组：使用Gyrus等离子体动力系统进行双极经尿道前列腺切除术（PK组）和单极经尿道前列腺切除术（标准TURP组）。所有患者在基线和随访（治疗后12个月）时通过病史、国际前列腺症状评分（包括生活质量问题）以及体格检查（包括直肠指检、经直肠超声检查和压力流研究）进行评估。对国际前列腺症状评分和尿动力学参数的变化进行统计分析，比较终点与基线情况，并比较两组之间的基线和随访特征。

结果

PK组和标准TURP组的平均切除时间分别为39.1分钟和31.7分钟（P = 0.437）。PK组随访24小时时平均术后血红蛋白降低1.25 g/dL，血细胞比容降低2.1%，标准TURP组平均降低1.81 g/dL，血细胞比容降低3.2%（P = 0.716）。两组在流速、国际前列腺症状评分、生活质量评分和膀胱出口梗阻分级方面的改善情况相当。