Benoist N, Bigot P, Colombel P, Amie F, Haringanji C, Chautard D, Azzouzi A R
Service d'urologie, faculté de médecine d'Angers, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 09, France.
Prog Urol. 2009 Jan;19(1):54-9. doi: 10.1016/j.purol.2008.07.010. Epub 2008 Oct 18.
To estimate the efficiency and morbidity of the radiofrequency (Tuna) for treatment of symptomatic benign prostatic hyperplasia (BPH) in patients with medical treatment failure.
Between September 2003 and July 2007, 31 patients, mean age 59,5 years (50-76), were treated for BPH with Tuna. Patients had initially received medical treatment, which happened to fail and Tuna was offered as surgical treatment. Available clinical data of 28 patients was retrospectively analyzed. Mictionnel status was estimated with International Prostatic Symptoms Score (IPSS), urinary peak flow (UPF) and post void residual urine (PVR). Quality of life issues were also addressed. Efficiency of treatment was estimated on the evolution of these parameters after an average follow-up of 20 months (5-47). To estimate morbidity of treatment, peroperative and late complications were assessed.
Twenty-eight patients were included in the study. At a mean follow-up of 20 months, a significant improvement of the mictionnel status was found for the IPSS, the quality of life, the Qmax (p<0,001) and the PVR (p<0,005) and quality of life. Morbidity was verified as minimal in the series. At a follow-up period of 20 months, 15 patients (53,6%) had stopped medical treatment, 10 patients (35,7%) pursued medical treatment and three patients (10,7%) had undergone another type of surgical treatment for BPH. The rate of re-treatment in the series was 46,4%. Among the group of patients without any medical treatment (15 patients), 10 patients reported satisfactory quality of life.
Tuna is a technique with significant good results for the treatment of LUTS-BPH. The main advantage of this technique is its low morbidity, however, the rate of retreatment was observed as high. Series of patients with long-term follow-up should provide evidence to objectively define the role of Tuna in BPH surgical treatment.
评估射频(Tuna)治疗药物治疗失败的有症状良性前列腺增生(BPH)患者的疗效及并发症发生率。
2003年9月至2007年7月,31例平均年龄59.5岁(50 - 76岁)的患者接受了Tuna治疗BPH。患者最初接受过药物治疗,但治疗失败,随后接受Tuna作为手术治疗。对28例患者的可用临床数据进行回顾性分析。通过国际前列腺症状评分(IPSS)、尿流率峰值(UPF)和排尿后残余尿量(PVR)评估排尿状况。还探讨了生活质量问题。在平均随访20个月(5 - 47个月)后,根据这些参数的变化评估治疗效果。为评估治疗的并发症发生率,对术中及术后并发症进行了评估。
28例患者纳入研究。平均随访20个月时,IPSS、生活质量、最大尿流率(Qmax,p<0.001)和PVR(p<0.005)以及生活质量方面的排尿状况有显著改善。该系列研究中证实并发症发生率极低。在20个月的随访期,15例患者(53.6%)停止了药物治疗,10例患者(35.7%)继续药物治疗,3例患者(10.7%)接受了另一种治疗BPH的手术治疗。该系列研究中的再次治疗率为46.4%。在未接受任何药物治疗的患者组(15例患者)中,10例患者报告生活质量令人满意。
Tuna是一种治疗下尿路症状性BPH效果显著的技术。该技术的主要优点是并发症发生率低,然而,观察到再次治疗率较高。长期随访的患者系列研究应能提供证据,以客观界定Tuna在BPH手术治疗中的作用。