Bach T, Herrmann T R W, Ganzer R, Blana A, Burchardt M, Gross A J
Urologische Abteilung, Asklepios-Klinik Barmbek, Hamburg.
Urologe A. 2009 May;48(5):529-34. doi: 10.1007/s00120-008-1931-y.
Laser treatment of benign prostatic hyperplasia has been introduced. The thulium:YAG (Tm:YAG) laser combines the advantages of established laser systems. This study reports the preliminary results of vaporesection of the prostate, using this 2-microm continuous wave (cw) laser.
A total of 54 consecutive patients were treated with the Tm:YAG laser. The outcomes measured were resection time, catheter time, improvement in urinary flow rate (Q(max)), and post-voiding residual urine (PVR). International Prostate Symptom Score (IPSS) and Quality of Life Index (QoL) were recorded.
The mean age was 61 years. Mean prostate volume was 30.3 cc. Average resection time was 52 min. Catheter time was 1.7 days. Qmax significantly improved from 4.2 to 20.9 ml on average. PVR decreased from 86 to 16 ml. IPSS and QoL score improved from 19.8 to 6.5 and 4 to 1, respectively. No patient required re-hospitalization. Transfusions were not necessary.
These preliminary results indicate that Tm:YAG vaporesection of the prostate is safe and efficient. The 18-month follow-up data showed major improvement in voiding symptoms and QoL. Longer follow-up is needed to prove durability of these promising results.
已引入激光治疗良性前列腺增生。铥激光(Tm:YAG)结合了现有激光系统的优点。本研究报告了使用这种2微米连续波(cw)激光进行前列腺汽化切除术的初步结果。
共有54例连续患者接受了Tm:YAG激光治疗。测量的结果包括切除时间、导尿管留置时间、尿流率(Q(max))改善情况及排尿后残余尿量(PVR)。记录国际前列腺症状评分(IPSS)和生活质量指数(QoL)。
平均年龄为61岁。平均前列腺体积为30.3立方厘米。平均切除时间为52分钟。导尿管留置时间为1.7天。Qmax平均从4.2显著提高到20.9毫升。PVR从86毫升降至16毫升。IPSS和QoL评分分别从19.8改善至6.5和从4改善至1。无患者需要再次住院。无需输血。
这些初步结果表明,Tm:YAG前列腺汽化切除术安全且有效。18个月的随访数据显示排尿症状和生活质量有显著改善。需要更长时间的随访来证明这些有前景的结果的持久性。