Hall Timothy L, Hempel Christopher R, Wojno Kirk, Xu Zhen, Cain Charles A, Roberts William W
Department of Urology, University of Michigan, Ann Arbor, Michigan, 4432 Med Sci 1, 1301 Catherine St, Ann Arbor, MI 48109, USA.
Urology. 2009 Oct;74(4):932-7. doi: 10.1016/j.urology.2009.03.049. Epub 2009 Jul 22.
To develop the technique of histotripsy ultrasound therapy as a noninvasive treatment for benign prostatic hyperplasia and to examine the histotripsy dose-tissue response effect over time to provide an insight for treatment optimization. We have previously demonstrated the feasibility of prostate histotripsy fractionation in a canine model.
Various doses of histotripsy were applied transabdominally to the prostates of 20 canine subjects. Treated prostates were then harvested at interval time points from 0 to 28 days and assessed for histologic treatment response.
The lowest dose applied was found to produce only scattered cellular disruption and necrosis, whereas higher doses produced more significant regions of tissue effect that resulted in sufficient fractionation of tissue so the material could be voided with urination. Urethral tissue was more resistant to the lower histotripsy doses than was parenchymal tissue. Treatment of the urethra at the lowest doses appeared to heal, with minimal long-term sequelae.
Histotripsy was effective at fractionating parenchymal and urethral tissue in the prostate, in the presence of a sufficient dose. Further development of this technique could lead to a noninvasive method for debulking the prostate to relieve symptoms associated with benign prostatic hyperplasia.
开发组织粉碎超声疗法作为良性前列腺增生的无创治疗技术，并研究组织粉碎剂量-组织反应随时间的效应，为治疗优化提供见解。我们之前已在犬模型中证明了前列腺组织粉碎分次治疗的可行性。
经腹部对20只犬的前列腺施加不同剂量的组织粉碎。然后在0至28天的不同时间点采集治疗后的前列腺，并评估组织学治疗反应。
发现应用的最低剂量仅产生散在的细胞破坏和坏死，而较高剂量产生更显著的组织效应区域，导致组织充分分次，使物质可随排尿排出。尿道组织比实质组织对较低的组织粉碎剂量更具抗性。最低剂量对尿道的治疗似乎可愈合，长期后遗症最少。
在有足够剂量的情况下，组织粉碎对前列腺实质和尿道组织进行分次有效。该技术的进一步发展可能会产生一种无创方法来缩小前列腺体积，以缓解与良性前列腺增生相关的症状。
