Department of Urology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Niaosung, Kaohsiung, Taiwan.
Urology. 2010 Mar;75(3):658-63. doi: 10.1016/j.urology.2009.09.033. Epub 2009 Dec 29.
To evaluate the efficacy and safety of a 200-W high-intensity diode laser in the treatment of benign prostatic hyperplasia.
The prostate was vaporized by using a side-firing laser fiber (diode laser: power, 150-200 W; wavelength, 980 nm; Limmer, Germany). The following parameters were assessed at baseline, and after a follow-up period of 1- and 6 months: International Prostate Symptom Score, maximum uroflow rate, postvoid residual urine volume, and quality of life score. Prostate volume and prostate-specific antigen levels were assessed at baseline and 6 months postoperatively.
This study included 55 patients diagnosed with lower urinary tract symptoms secondary to BPH, who were treated between December 2007 and July 2008. The recatheterization rate was 10.9%. None of these patients required a blood transfusion or had transurethral resection syndrome. Statistically significant improvements (P < .001) were observed in the values of International Prostate Symptom Score, Q(max), postvoid residual urine volume, and quality of life score at 1- and 6 months of follow-up as compared with the respective baseline values. Transient urge incontinence was noted in 8 patients (8/55, 14.5%).Sloughing of necrotic tissues was observed on cystoscopy in 8 patients within several weeks or months after the operation. The retreatment rate (secondary transurethral resection of the prostate) was 7.3%.
From our preliminary data, it was evident that diode laser prostatectomy can achieve excellent hemostasis, and provide immediate relief from obstructive voiding symptoms. However, the postoperative irritative symptoms and sloughing of necrotic tissues remained to be an important issue that needed to be resolved.
评估 200W 高强度二极管激光治疗良性前列腺增生的疗效和安全性。
使用侧射激光光纤（二极管激光：功率 150-200W，波长 980nm，Limmer，德国）汽化前列腺。在基线时以及随访 1 个月和 6 个月后评估以下参数：国际前列腺症状评分、最大尿流率、残余尿量和生活质量评分。在基线和术后 6 个月评估前列腺体积和前列腺特异性抗原水平。
本研究纳入了 2007 年 12 月至 2008 年 7 月间因良性前列腺增生导致下尿路症状的 55 例患者。再置管率为 10.9%。这些患者均无需输血或出现经尿道切除综合征。与基线值相比，在 1 个月和 6 个月随访时，国际前列腺症状评分、Q(max)、残余尿量和生活质量评分均有显著改善（P<0.001）。8 例患者（8/55，14.5%）出现短暂性急迫性尿失禁。术后数周至数月内，8 例患者在膀胱镜下观察到坏死组织脱落。再次治疗率（二次经尿道前列腺切除术）为 7.3%。
根据我们的初步数据，二极管激光前列腺切除术可以实现良好的止血效果，并立即缓解梗阻性排尿症状。然而，术后刺激性症状和坏死组织脱落仍然是一个需要解决的重要问题。
