Magno Carlo, Mucciardi Giuseppe, Galì Alessandro, Anastasi Giuseppina, Inferrera Antonino, Morgia Giuseppe
Department of Urology, University of Messina, Via Consolare Valeria, Messina, 98100, Italy.
Int Urol Nephrol. 2008;40(4):941-6. doi: 10.1007/s11255-008-9394-z. Epub 2008 May 14.
To evaluate the efficacy and safety of transurethral ethanol ablation of the prostate (TEAP) for patients with symptomatic benign prostatic hyperplasia (BPH) and high-risk comorbidities.
Thirty-six patients (mean age 77.3 years) with symptomatic BPH or persistent urinary retention were assessed at baseline and at 3, 6, and 12 months after treatment. All patients were affected by comorbidities (cardiovascular, respiratory, hematologic, neoplastic, dysmetabolic diseases, or coagulation disorders). Baseline evaluation was achieved by the International Prostate Symptom Score (IPSS) and quality of life (QoL) score, prostate-specific antigen (PSA), prostate transrectal ultrasound (TRUS), and the maximum peak flow rate with evaluation of post-voiding residual urine volume (PVR). Treatment was performed by injecting dehydrated ethanol at a rate correlated to prostate volume into the prostate. The primary end-point for response was > or = 80% improvement of the maximum peak flow rate and significant reduction of the PVR; secondary end-points included symptom improvement (> or = 40% reduction in IPSS and QoL scores). Statistical analysis was carried out with Pearson's Chi-square test and the non-parametric Wilcoxon test with an assigned statistical significance at P < 0.05.
During the active follow-up period, we observed a statistically significant decrease of the baseline at the end of the study in the total IPSS score and in the QoL score. The mean peak flow rate improved from 6.0 +/- 2.40 ml/min to 15.2 +/- 0.14 ml/min (P < 0.001), while the PVR decreased from a baseline value of 290.6 +/- 14.14 ml to 4.2 +/- 14.10 ml (P < 0.001).
We found that TEAP is a safe minimally invasive treatment, which significantly improves voiding dysfunctions in patients with symptomatic BPH.
评估经尿道乙醇消融前列腺术（TEAP）对有症状的良性前列腺增生（BPH）及高危合并症患者的疗效和安全性。
对36例有症状的BPH或持续性尿潴留患者（平均年龄77.3岁）在基线期以及治疗后3个月、6个月和12个月进行评估。所有患者均患有合并症（心血管、呼吸、血液、肿瘤、代谢紊乱疾病或凝血障碍）。通过国际前列腺症状评分（IPSS）和生活质量（QoL）评分、前列腺特异性抗原（PSA）、经直肠前列腺超声（TRUS）以及排尿后残余尿量（PVR）评估的最大尿流率进行基线评估。通过以与前列腺体积相关的速率向前列腺内注射脱水乙醇来进行治疗。反应的主要终点是最大尿流率改善≥80%且PVR显著降低；次要终点包括症状改善（IPSS和QoL评分降低≥40%）。采用Pearson卡方检验和非参数Wilcoxon检验进行统计分析，设定统计学显著性为P<0.05。
在积极随访期间，我们观察到研究结束时总IPSS评分和QoL评分较基线有统计学显著下降。平均尿流率从6.0±2.40毫升/分钟提高到15.2±0.14毫升/分钟（P<0.001），而PVR从基线值290.6±14.14毫升降至4.2±14.10毫升（P<0.001）。
我们发现TEAP是一种安全的微创治疗方法，可显著改善有症状的BPH患者的排尿功能障碍。
