Lee Chang Ju, Cho Min Chul, Ku Ja Hyeon, Kim Soo Woong, Paick Jae-Seung
Department of Urology, Seoul National University College of Medicine, Seoul, Korea.
Korean J Urol. 2010 Aug;51(8):531-6. doi: 10.4111/kju.2010.51.8.531. Epub 2010 Aug 18.
To investigate changes in nocturia and predictive factors for improvement after photoselective vaporization of the prostate (PVP) for patients with benign prostatic hyperplasia (BPH).
A total of 103 patients who complained of nocturia of >/=2 times per night on baseline frequency-volume chart (FVC) and who underwent PVP were included in this retrospective study. All patients underwent a preoperative evaluation for BPH including multichannel video urodynamics. The efficacy of the PVP was evaluated at 1, 3, 6, and 12 months postoperatively by use of the International Prostate Symptom Score (IPSS) and FVC. Subjective and objective improvement of nocturia were defined as a reduction of >/=50% in nocturnal frequency compared with baseline on the IPSS and FVC, respectively.
As shown by the IPSS and FVC, nocturia was significantly reduced starting from 1 month after PVP. The percentage of patients with improvement in nocturia was 20.0%, 20.7%, 36.2%, and 27.9% on the IPSS, and 30.1%, 48.6%, 52.2%, and 54.5% on the FVC at 1, 3, 6, and 12 months after PVP, respectively. None of the baseline parameters, including the presence or absence of nocturnal polyuria (NPU), reduced nocturnal bladder capacity (NBC), and detrusor overactivity (DO), were associated with improvement of nocturia.
Nocturnal frequency was significantly reduced from the early postoperative period after PVP. Improvement in nocturia after PVP was not affected by baseline nocturnal frequency, the presence or absence of preoperative NPU, or reduced NBC or DO on baseline urodynamics.
探讨良性前列腺增生(BPH)患者经尿道前列腺选择性光汽化术(PVP)后夜尿症的变化及改善的预测因素。
本回顾性研究纳入了103例在基线频率 - 容量图(FVC)上每晚夜尿≥2次且接受了PVP的患者。所有患者均接受了包括多通道视频尿动力学检查在内的BPH术前评估。术后1、3、6和12个月,采用国际前列腺症状评分(IPSS)和FVC评估PVP的疗效。夜尿症的主观和客观改善分别定义为IPSS和FVC上夜间排尿频率较基线降低≥50%。
IPSS和FVC显示,PVP术后1个月起夜尿症明显减少。PVP术后1、3、6和12个月,IPSS上夜尿症改善患者的百分比分别为20.0%、20.7%、36.2%和27.9%,FVC上分别为30.1%、48.6%、52.2%和54.5%。包括夜间多尿(NPU)的有无、夜间膀胱容量(NBC)降低和逼尿肌过度活动(DO)在内的所有基线参数均与夜尿症的改善无关。
PVP术后早期夜间排尿频率明显降低。PVP术后夜尿症的改善不受基线夜间排尿频率、术前NPU的有无或基线尿动力学检查中NBC降低或DO的影响。