Department of Urology, Sant'Andrea Hospital, University La Sapienza, Rome, Italy.
J Urol. 2010 Mar;183(3):1098-103. doi: 10.1016/j.juro.2009.11.050. Epub 2010 Jan 21.
We evaluated voiding and storage symptom evolution in patients treated with prostate photoselective vaporization by a KTP laser.
Enrolled in the study were 150 consecutive patients with lower urinary tract symptoms due to benign prostatic hyperplasia and a diagnosis of bladder outlet obstruction. Patients underwent prostate photoselective vaporization with the 80 W KTP laser. Baseline parameters included prostate volume, International Prostate Symptom Score with voiding and storage symptom subscores, uroflowmetry, pressure flow study and serum prostate specific antigen. Patients were followed 1, 3, 6 and 12 months after surgery.
Mean +/- SD patient age was 69.6 +/- 10 years. Mean prostate volume was 52 +/- 18 ml. Mean International Prostate Symptom Score was 22.3 +/- 4, mean maximum urine flow was 9 +/- 2.9 ml per second and mean Schäfer obstruction class was 3.6 +/- 1. An average of 190 +/- 44 kJ were delivered in a mean of 68 +/- 24 minutes with an average of 3.6 kJ/ml prostate. The mean number of fibers was 1.2 +/- 0.4. Mean catheterization time was 20 +/- 8 hours. Retrograde ejaculation was reported in 67% of patients. Prostate specific antigen was significantly decreased at 12 months (2.6 +/- 2.3 vs 0.9 +/- 0.7 ng/ml, p = 0.001). Storage symptoms decreased by 54.5%, 63.6%, 72.7% and 81.8% at 1, 3, 6 and 12 months, respectively (p <0.001). Voiding symptoms decreased 63.6%, 72.7%, 81.8% and 90.9% at 1, 3, 6 and 12 months, respectively (p <0.001).
As shown by a prostate specific antigen significant decrease, proper prostate debulking may be achieved by prostate photoselective vaporization. Significant continuous improvement in storage and voiding symptoms was observed at up to 12-month followup.
我们评估了经 KTP 激光前列腺光选择性汽化治疗患者的排尿和储尿症状演变。
本研究纳入了 150 例因良性前列腺增生和膀胱出口梗阻而出现下尿路症状的连续患者。患者接受 80 W KTP 激光前列腺光选择性汽化治疗。基线参数包括前列腺体积、排尿和储尿症状子评分的国际前列腺症状评分、尿流率、压力流研究和血清前列腺特异性抗原。患者在术后 1、3、6 和 12 个月进行随访。
患者平均年龄为 69.6±10 岁。平均前列腺体积为 52±18ml。国际前列腺症状评分平均为 22.3±4，最大尿流率平均为 9±2.9ml/秒， Schäfer 梗阻分级平均为 3.6±1。平均输送 190±44kJ，平均 68±24 分钟，平均 3.6kJ/ml 前列腺。平均纤维数为 1.2±0.4。平均导尿时间为 20±8 小时。67%的患者报告出现逆行射精。前列腺特异性抗原在 12 个月时显著下降（2.6±2.3 对 0.9±0.7ng/ml，p=0.001）。储尿症状分别在 1、3、6 和 12 个月时减少了 54.5%、63.6%、72.7%和 81.8%（p<0.001）。排尿症状分别在 1、3、6 和 12 个月时减少了 63.6%、72.7%、81.8%和 90.9%（p<0.001）。
如前列腺特异性抗原显著下降所示，前列腺光选择性汽化术可能实现适当的前列腺切除术。在长达 12 个月的随访中，观察到储尿和排尿症状的持续显著改善。
