Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan.
BJU Int. 2010 May;105(10):1429-33. doi: 10.1111/j.1464-410X.2009.08978.x. Epub 2009 Oct 26.
To investigate whether bladder outlet obstruction (BOO), detrusor underactivity (DUA) and detrusor overactivity (DO) affect the long-term outcome of transurethral resection of the prostate (TURP) for patients having lower urinary tract symptoms suggestive of benign prostatic obstruction.
Of 92 patients who had TURP after a urodynamic study between 1995 and 1997, 43 (47%) were alive at the time of the survey in February 2008. Nine patients were excluded because of prostate cancer, neurological diseases and the impossibility of symptomatic examination. The International Prostate Symptom Score (IPSS) and quality-of-life (QoL) index were determined at baseline, 3 months, 3, 7 and 12 years after surgery for 34 patients.
Although the improved IPSS and QoL index at 3 months gradually deteriorated with time, patients at 12 years were still significantly better than those at baseline. The IPSS in patients without BOO deteriorated faster than in those with it, whereas neither DUA nor DO influenced the slope of change in IPSS. Regardless of the preoperative urodynamic findings, the QoL index remained improved for 12 years. Two-thirds of patients with DUA but not BOO were satisfied with their urinary condition at 12 years.
The symptomatic improvement provided by TURP lasts for >10 years, although there is a gradual deterioration with time. The QoL index remained improved for 12 years regardless of the preoperative urodynamic findings.
研究膀胱出口梗阻(BOO)、逼尿肌乏力(DUA)和逼尿肌过度活动(DO)是否会影响经尿道前列腺切除术(TURP)治疗有下尿路症状提示良性前列腺梗阻患者的长期疗效。
1995 年至 1997 年间,92 例行尿动力学检查的患者接受了 TURP,2008 年 2 月调查时,其中 43 例(47%)仍存活。9 例患者因前列腺癌、神经疾病和症状检查不可能而被排除。34 例患者在基线、术后 3 个月、3、7 和 12 年时分别测定国际前列腺症状评分(IPSS)和生活质量(QoL)指数。
尽管术后 3 个月时 IPSS 和 QoL 指数改善逐渐恶化,但 12 年后仍明显优于基线。无 BOO 的患者 IPSS 恶化更快,而 DU A 或 DO 均不影响 IPSS 变化的斜率。无论术前尿动力学检查结果如何,QoL 指数在 12 年内仍保持改善。2/3 的 DUA 但无 BOO 的患者在 12 年后对其排尿状况满意。
尽管随时间推移逐渐恶化,但 TURP 提供的症状改善持续>10 年。无论术前尿动力学检查结果如何,QoL 指数在 12 年内仍保持改善。