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980纳米侧向发射二极管激光选择性光汽化治疗良性前列腺增生症的初步结果:一种保留射精功能的技术。

Preliminary results on selective light vaporization with the side-firing 980 nm diode laser in benign prostatic hyperplasia: an ejaculation sparing technique.

作者信息

Leonardi R

机构信息

Department of Urology, Clinica Basile, Catania, Italy.

出版信息

Prostate Cancer Prostatic Dis. 2009;12(3):277-80. doi: 10.1038/pcan.2009.5. Epub 2009 Mar 24.

Abstract

This study examined efficacy and safety of the 980 nm side-firing diode laser operating at a power of 100 W in patients with lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH). Patients were selected for surgery on the basis of maximum urinary flow rate (Qmax) <or=15 ml/s or transvesically measured post-voiding residual volume (PVR) >100 ml in conjunction with an International Prostate Symptom Score (IPSS) >7. Laser therapy was conducted under spinal anaesthesia. Qmax, IPSS, prostate volume, PVR, IPSS-Quality of Life (QoL) questionnaire and ejaculatory function were measured at baseline and at 1, 3, 6 and 12 months post-laser therapy. A total of 52 consecutive patients aged 52-65 years with mean (s.d.) prostate volume of 45.14 (9.15) g were treated. All patients were able to leave the hospital at a mean (s.d.) of 5 (2) h after the procedure. Mean (s.d.) follow-up was 100 (75.49) days. A significant reduction in IPPS was reported at 1 month (P<0.0001) and this was maintained through to 6 months. Significant durable improvements in Qmax, PVR and IPSS-QoL score were also reported for all patients (P<0.0001). No severe complications were reported, including any cases of urinary incontinence or significant irritative symptoms. None of the patients complained of a worsening of erectile function. This early experience in a pilot study with the 980 nm diode laser seems promising in the short-term and long-term outcome is being monitored.

摘要

本研究考察了功率为100W的980nm侧向发射二极管激光治疗与良性前列腺增生(BPH)相关的下尿路症状患者的疗效和安全性。入选患者进行手术的标准为最大尿流率(Qmax)≤15ml/s或经膀胱测量的排尿后残余尿量(PVR)>100ml,同时国际前列腺症状评分(IPSS)>7。激光治疗在脊髓麻醉下进行。在基线以及激光治疗后1、3、6和12个月测量Qmax、IPSS、前列腺体积、PVR、IPSS生活质量(QoL)问卷和射精功能。共治疗了52例年龄在52 - 65岁之间、平均(标准差)前列腺体积为45.14(9.15)g的连续患者。所有患者术后平均(标准差)5(2)小时即可出院。平均(标准差)随访时间为100(75.49)天。1个月时IPSS显著降低(P<0.0001),并持续至6个月。所有患者的Qmax, PVR和IPSS - QoL评分也有显著持久改善(P<0.0001)。未报告严重并发症,包括任何尿失禁或明显刺激症状的病例。没有患者抱怨勃起功能恶化。这项关于980nm二极管激光的初步研究的早期经验在短期看来很有前景,长期结果正在监测中。

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