Division of Urology, Department of Surgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
J Urol. 2010 Nov;184(5):2023-8. doi: 10.1016/j.juro.2010.06.107. Epub 2010 Sep 17.
We evaluated the long-term results and durability of photoselective vaporization and holmium laser ablation as surgical treatment of small to medium prostates in a prospective, randomized study in men with obstructive benign prostatic hyperplasia.
From March 2005 to April 2007 we randomly allocated 109 patients with a prostate gland of less than 60 cc to prostate photoselective vaporization (52) or holmium laser ablation (57) and evaluated them 1, 2 and 3 years postoperatively. Functional followup included measurement of maximum urinary flow rate, post-void residual urine, International Prostate Symptom Score, quality of life, International Index of Erectile Function and prostate specific antigen.
Mean ± SD preoperative prostate volume was 33.1 ± 14.5 and 37.3 ± 13.6 in the laser ablation and vaporization groups, respectively. All functional parameters improved significantly compared to baseline values in each group. There was no difference in International Prostate Symptom Score, quality of life, maximum urinary flow rate, post-void residual urine or percent of prostate specific antigen decrease between the 2 groups 1, 2 and 3 years postoperatively. At 3-year followup International Prostate Symptom Score had improved by 70.5%, quality of life had improved by 69.4%, maximum urinary flow rate had increased by 164% and post-void residual urine had decreased by 81% in the holmium laser ablation group. In the photoselective vaporization group International Prostate Symptom Score improved by 64.1%, quality of life improved by 65.5%, maximum urinary flow rate increased by 189% and post-void residual urine decreased by 79.5%. The overall re-treatment rate was 15.8% for holmium laser ablation vs 19.3% for photoselective vaporization.
Prostate photoselective vaporization and holmium laser ablation are effective surgical treatments for benign prostatic hyperplasia. Postoperative functional improvements were significant and durable, and equivalent in the 2 groups. The 2 techniques have a similar complication rate.
我们通过前瞻性、随机研究，评估了对有梗阻性良性前列腺增生的小至中型前列腺患者进行光选择性汽化和钬激光消融的长期效果和耐用性。
2005 年 3 月至 2007 年 4 月，我们将 109 例前列腺体积小于 60cc 的患者随机分为前列腺光选择性汽化组（52 例）和钬激光消融组（57 例），并在术后 1、2、3 年对他们进行评估。功能随访包括测量最大尿流率、剩余尿量、国际前列腺症状评分、生活质量、国际勃起功能指数和前列腺特异抗原。
平均±SD 术前前列腺体积分别为 33.1±14.5 和 37.3±13.6，两组所有功能参数与术前相比均有显著改善。两组术后 1、2、3 年的国际前列腺症状评分、生活质量、最大尿流率、剩余尿量和前列腺特异抗原下降百分比均无差异。在 3 年随访时，钬激光消融组的国际前列腺症状评分改善了 70.5%，生活质量改善了 69.4%，最大尿流率增加了 164%，剩余尿量减少了 81%。光选择性汽化组的国际前列腺症状评分改善了 64.1%，生活质量改善了 65.5%，最大尿流率增加了 189%，剩余尿量减少了 79.5%。钬激光消融组的总再治疗率为 15.8%，光选择性汽化组为 19.3%。
前列腺光选择性汽化和钬激光消融是治疗良性前列腺增生的有效手术方法。术后功能改善显著且持久，两组效果相当。两种技术的并发症发生率相似。
