Fu Wei-Jun, Hong Bao-Fa, Yang Yong, Zhang Xu, Gao Jiang-Ping, Zhang Lei, Wang Xiao-Xiong
Department of Urology, Chinese People's Liberation Army General Hospital, Military Postgraduate Medical College, Beijing, People's Republic of China.
BJU Int. 2009 Feb;103(3):352-6. doi: 10.1111/j.1464-410X.2008.08040.x. Epub 2008 Sep 3.
To explore the safety and clinical efficacy of continuous-wave laser vaporesection for the treatment of obstructive benign prostatic hyperplasia (BPH).
We treated 72 consecutive patients with obstructive BPH using a 70 W 2-microm continuous-wave laser. The mean (range) age of the patients was 68.6 (52-86) years. Before laser treatment, the patients were examined. The mean (SD, range) prostatic volume was 65.8 (21.7, 36-108) mL. The operative outcomes assessed were: resection time, transfusion rate, catheter time, and haemoglobin and serum sodium levels. The following variables were assessed before and after vaporesection: maximum urinary flow rate (Qmax), postvoiding residual urine volume (PVR), International Prostate Symptom Score (IPSS), Quality of Life Index (QoL) and sexual function.
All cases were successful using general (two cases), epidural (28) or sacral block regional anaesthesia (42). The mean (SD) vaporesection time was 56 (12.8) min. None of the patients required a transfusion. The mean (SD) catheter time was 1.7 (0.6) days. The mean Qmax increased from 5.7 (1.2) mL/s before to 20.8 (2.1) mL/s after vaporesection and the PVR decreased from 150 to 36 mL. The IPSS and QoL scores improved after vaporesection from 24.6 (4.5) to 6.8 (1.2) and 4.8 (0.2) to 1.4 (0.3), respectively (P < 0.05). Apart from transient dysuria (8%) and irritative symptoms (29%), all patients were satisfied with voiding outcome after vaporesection and none had incontinence.
Vaporesection using the 2-microm continuous-wave laser for the treatment of obstructive BPH is a safe and effective ablative procedure with minimal morbidity and rare bleeding.
探讨连续波激光汽化切除术治疗梗阻性良性前列腺增生（BPH）的安全性和临床疗效。
我们使用70W 2微米连续波激光连续治疗72例梗阻性BPH患者。患者的平均（范围）年龄为68.6（52 - 86）岁。在激光治疗前，对患者进行了检查。平均（标准差，范围）前列腺体积为65.8（21.7，36 - 108）mL。评估的手术结果包括：切除时间、输血率、导尿管留置时间以及血红蛋白和血清钠水平。在汽化切除术前和术后评估以下变量：最大尿流率（Qmax）、排尿后残余尿量（PVR）、国际前列腺症状评分（IPSS）、生活质量指数（QoL）和性功能。
所有病例均采用全身麻醉（2例）、硬膜外麻醉（28例）或骶管阻滞区域麻醉（42例）成功完成手术。平均（标准差）汽化切除时间为56（12.8）分钟。所有患者均无需输血。平均（标准差）导尿管留置时间为1.7（0.6）天。平均Qmax从汽化切除术前的5.7（1.2）mL/s增加到术后的20.8（2.1）mL/s，PVR从150 mL降至36 mL。汽化切除术后IPSS和QoL评分分别从24.6（4.5）改善至6.8（1.2）以及从4.8（0.2）改善至1.4（0.3）（P < 0.05）。除了短暂性排尿困难（8%）和刺激性症状（29%）外，所有患者对汽化切除术后的排尿结果均满意，且无尿失禁发生。
使用2微米连续波激光汽化切除术治疗梗阻性BPH是一种安全有效的消融手术，发病率极低且出血罕见。
