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经直肠高强度聚焦超声治疗良性前列腺增生:262例报告

[Transrectal high-intensity focused ultrasound for treatment of benign prostatic hyperplasia: report of 262 cases].

作者信息

Xu Wen-feng, Zhang Hai-bin, Lin Zhe, Yang Ming, Liu Jian-hua, Ye Shan, Chen Yong, Yu Yue-yi

机构信息

Department of Urology, Foshan First People's Hospital, Foshan 528000, China.

出版信息

Nan Fang Yi Ke Da Xue Xue Bao. 2010 Aug;30(8):1906-8.

Abstract

OBJECTIVE

To explore the application of transrectal high-intensity focused ultrasound (HIFU) for treatment of benign prostatic hyperplasia (BPH).

METHODS

From Dec. 2002 to Dec. 2006, 262 BPH patients underwent transrectal HIFU ablative therapy. After the treatment, IPSS, QOL score, peak uroflow rate and prostatic volume measured by TRUS were used for evaluation.

RESULTS

After 1 to 3 years' follow-up, IPSS, QOL score, and prostatic volume all decreased, while the peak uroflow rate increased obviously (P<0.01). Mild hematuria was noted in all the cases after the treatment, and epididymitis was found in 7 cases (2.7%), short-term hematospermia in 66 cases (25.2%), retrograde ejaculation in 35 cases (13.4%), and urethro-rectal fistula in 1 case (0.3%). No urinary incontinence was found in these cases. TURP was performed in 18 cases (6.8%) in 3 years after the treatment due to an excessively large volume of the prostates or bladder neck contracture.

CONCLUSION

HIFU is effective and safe in the treatment of BPH which causes minimal invasion, absence of intraoperative bleeding, good tolerance and few complications, and is especially suitable in elderly patients.

摘要

目的

探讨经直肠高强度聚焦超声(HIFU)治疗良性前列腺增生症(BPH)的应用。

方法

2002年12月至2006年12月,262例BPH患者接受经直肠HIFU消融治疗。治疗后,采用国际前列腺症状评分(IPSS)、生活质量(QOL)评分、经直肠超声(TRUS)测量的最大尿流率及前列腺体积进行评估。

结果

随访1至3年,IPSS、QOL评分及前列腺体积均下降,最大尿流率明显增加(P<0.01)。治疗后所有患者均出现轻度血尿,7例(2.7%)发生附睾炎,66例(25.2%)出现短期血精,35例(13.4%)出现逆行射精,1例(0.3%)发生尿道直肠瘘。这些患者均未出现尿失禁。治疗后3年内,18例(6.8%)因前列腺体积过大或膀胱颈挛缩接受了经尿道前列腺电切术(TURP)。

结论

HIFU治疗BPH有效且安全,具有微创、术中无出血、耐受性好、并发症少等优点,尤其适用于老年患者。

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