Benejam Gual J, Díez-Caballero Alonso F, García-Miralles Grávalos R, Servera Ruiz de Velasco A
Servicio de Urología, Fundación Hospital de Manacor, Manacor, Mallorca, España.
Actas Urol Esp. 2010 Feb;34(2):170-5.
To assess the efficacy and safety of photovaporization of the prostate with Greenlight HPS laser as major outpatient surgery.
A prospective study was conducted of a cohort of 50 patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia who underwent photovaporization with Greenlight HPS laser (120 W) as major outpatient surgery from May 2008 to February 2009. Inclusion criteria were moderate to severe obstructive lower urinary tract symptoms (IPSS of 10 or more and flowmetry with Qmax of 10 ml/sec or less due to benign prostatic hyperplasia with prostate volume less than 80 ml. Preoperative assessment included IPSS; flowmetry; physical examination; ultrasound examination of the kidney, bladder, and prostate (retropubic and transrectal); and measurement of postvoid residue and PSA levels. Surgical data were assessed (vaporization time, operating time, joules, complications during and after surgery). Patients were followed up 1 and 3 months after surgery (PSA, flow rate, IPSS questionnaire).
No patient admission or readmission was required, and bladder catheter was successfully removed from all patients within 24 hours of surgery. Mean patient age was 66.75 years. Mean prostate volume was 44.5 ml (SD + or - 21). Twenty patients (40%) had prior catheterization. Qmax and postvoid values significantly improved. Major complications at follow-up included voiding syndrome-urgency in 6 patients (12%) and mild transient hematuria in 3 patients (6%).
Photovaporization of the prostate with Greenlight HPS laser may be safely and successfully performed as a major outpatient surgical procedure, which undoubtedly represents a change in care, for surgical treatment of patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia.
评估以Greenlight HPS激光进行前列腺光汽化术作为主要门诊手术的疗效和安全性。
对2008年5月至2009年2月期间50例因良性前列腺增生继发下尿路症状的患者进行前瞻性研究，这些患者接受了以Greenlight HPS激光（120瓦）进行的前列腺光汽化术作为主要门诊手术。纳入标准为中度至重度梗阻性下尿路症状（国际前列腺症状评分10分及以上，因良性前列腺增生且前列腺体积小于80毫升导致最大尿流率Qmax为10毫升/秒及以下的尿流率测定）。术前评估包括国际前列腺症状评分；尿流率测定；体格检查；肾脏、膀胱和前列腺的超声检查（耻骨后和经直肠）；以及残余尿量和前列腺特异抗原水平的测量。评估手术数据（汽化时间、手术时间、能量、手术中和手术后的并发症）。患者在手术后1个月和3个月进行随访（前列腺特异抗原、尿流率、国际前列腺症状评分问卷）。
无需患者住院或再次入院，所有患者均在手术后24小时内成功拔除膀胱导管。患者平均年龄为66.75岁。平均前列腺体积为44.5毫升（标准差±21）。20例患者（40%）曾有过导尿史。最大尿流率和残余尿量值显著改善。随访时的主要并发症包括6例患者（12%）出现排尿综合征 - 尿急和3例患者（6%）出现轻度短暂血尿。
以Greenlight HPS激光进行前列腺光汽化术作为主要门诊手术可安全、成功地实施，这无疑代表了对良性前列腺增生继发下尿路症状患者手术治疗护理方式的一种改变。
