Djavan Bob, Eckersberger Elisabeth, Handl Markus Johannes, Brandner Roland, Sadri Helen, Lepor Herbert
Department of Urology, New York University Hospital, New York, New York 10016, USA.
Can J Urol. 2010 Aug;17(4):5249-54.
Transurethral resection of the prostate (TURP) has been the gold standard of the treatment of benign prostatic hyperplasia (BPH). In recent years there has been a significant shift in the treatment of BPH and guidelines emphasize minimally invasive surgery as a new treatment option. Minimal invasive technologies (MITs), such as transurethral microwave thermotherapy (TUMT), laser ablations, transurethral needle ablation (TUNA) have emerged as an alternative to the TURP.
To assess the retreatment rates of the most commonly used minimal invasive techniques.
Durability articles were selected by using defined search terms using PubMed as search engine.
Comparing to the overall retreatment rates of MITs the results show that TUMT, holmium laser enucleation of the prostate (HoLEP) and contact laser vaporization (CLV) are among the treatments with the lowest retreatment rates. Studies show no significant differences in retreatment rates between TUMT and TURP.
A review of the current literature, long term results and retreatment rates of MITs shows large variability in outcomes and retreatment rates. The true definition of a MIT remains unclear. High energy TUMT deserves reconsideration in clinical practices, due to low retreatment rates and the low need of anesthetics.
经尿道前列腺切除术(TURP)一直是良性前列腺增生(BPH)治疗的金标准。近年来,BPH的治疗发生了重大转变,指南强调微创手术作为一种新的治疗选择。微创技术(MITs),如经尿道微波热疗(TUMT)、激光消融、经尿道针刺消融(TUNA)已成为TURP的替代方法。
评估最常用的微创技术的再次治疗率。
以PubMed为搜索引擎,使用定义的检索词选择耐久性文章。
与MITs的总体再次治疗率相比,结果显示TUMT、钬激光前列腺剜除术(HoLEP)和接触式激光汽化术(CLV)是再次治疗率最低的治疗方法之一。研究表明,TUMT和TURP之间的再次治疗率没有显著差异。
对当前文献、MITs的长期结果和再次治疗率的回顾表明,结果和再次治疗率存在很大差异。MIT的真正定义仍不清楚。由于再次治疗率低且麻醉需求低,高能TUMT在临床实践中值得重新考虑。