Hamann Moritz F, Naumann Carsten M, Seif Christof, van der Horst Christof, Jünemann Klaus-Peter, Braun Peter M
Department of Urology and Pediatric Urology, University of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 7, Kiel, Germany.
Eur Urol. 2008 Oct;54(4):902-7. doi: 10.1016/j.eururo.2008.05.003. Epub 2008 May 16.
We determined the impact of potassium-titanyl-phosphate (KTP) laser therapy of the prostate on urodynamic results, voiding function, quality of life, and sexual function.
DESIGN, SETTING, AND PARTICIPANTS: Forty-five patients complaining of symptomatic benign prostatic hyperplasia (BPH) and urodynamically proven obstructive voiding were included in the prospective study. Follow-up exams were repeated 3 mo and 12 mo after the treatment.
All patients underwent photoselective 80-Watt KTP laser vaporisation of the prostate performed by two experienced surgeons.
Disease-specific quality of life and sexual function were assessed using the International Prostate Symptom Score (IPSS) and International Inventory of Erectile Function (IIEF). Video-urodynamics were carried out to determine changes in pressure flow and bladder function.
The average preoperative prostate volume was 47.63 ml (range 30-75 m). The mean preoperative PSA-value, which had been 3.5 ng/ml (range 0.13-7 ng/ml) initially, dropped by 34.2% after 3 mo and 37.1% after 12 mo. Despite transient micturition complaints (40%), all patients showed significant improvement in the IPSS in urinary peak flow and detrusor pressure at peak flow. The mean post-void residual urine volume decreased, while erectile function and libido scores remained unaffected by the procedure according to the IIEF. Detrusor contractility was also not affected in any of the patients. The single-centre study design and small number of patients may have limited the study results.
KTP laser therapy of the prostate achieves significant improvements both symptomatically as well as with respect to objective micturition parameters. The procedure leads to a functional deobstruction of the lower urinary tract with steady improvement results throughout the follow up period.
我们确定了磷酸钛氧钾（KTP）激光前列腺治疗对尿动力学结果、排尿功能、生活质量和性功能的影响。
设计、地点和参与者：45例有症状的良性前列腺增生（BPH）且经尿动力学证实存在梗阻性排尿的患者纳入了这项前瞻性研究。治疗后3个月和12个月重复进行随访检查。
所有患者均由两位经验丰富的外科医生进行80瓦KTP激光前列腺选择性汽化术。
使用国际前列腺症状评分（IPSS）和国际勃起功能量表（IIEF）评估特定疾病的生活质量和性功能。进行视频尿动力学检查以确定压力流和膀胱功能的变化。
术前前列腺平均体积为47.63毫升（范围30 - 75毫升）。术前平均前列腺特异性抗原（PSA）值最初为3.5纳克/毫升（范围0.13 - 7纳克/毫升），3个月后下降了34.2%，12个月后下降了37.1%。尽管有短暂的排尿主诉（40%），但所有患者的IPSS在尿流率峰值和峰值流率时逼尿肌压力方面均有显著改善。平均排尿后残余尿量减少，而根据IIEF，勃起功能和性欲评分在手术后未受影响。所有患者的逼尿肌收缩力也未受影响。单中心研究设计和患者数量少可能限制了研究结果。
KTP激光前列腺治疗在症状以及客观排尿参数方面均取得了显著改善。该手术导致下尿路功能性解除梗阻，在整个随访期间效果持续改善。
