Leonardi R
Department of Urology, Clinica Basile, Catania, Italy.
Prostate Cancer Prostatic Dis. 2009;12(3):277-80. doi: 10.1038/pcan.2009.5. Epub 2009 Mar 24.
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.
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。