CHU de Bordeaux Pellegrin, Bordeaux-2 Victor Segalen University, Bordeaux, France.
BJU Int. 2012 Aug;110(4):555-60. doi: 10.1111/j.1464-410X.2010.09806.x. Epub 2010 Nov 2.
Study Type - Therapy (multi-centre cohort). Level of Evidence 2b.
To evaluate the early functional outcomes of transurethral plasma vaporization of the prostate (TUVis) in a multicentre study.
A prospective multicentre observational study was conducted in eight urology departments. The inclusion criterion was benign prostatic hyperplasia (BPH) requiring surgical treatment. Patients on anti-coagulant therapy were not excluded. The TUVis procedure was performed according to a classic transurethral resection of the prostate (TURP) scheme following the manufacturer's recommendations. We evaluated subjective functional outcome using self-questionnaires (International Prostate Symptom Score [IPSS] and five-item International Index of Erectile Function [IIEF-5]) and objective criteria (prostate volume, prostate-specific antigen [PSA], uroflowmetry, post residual volume) at baseline and at 1- and 3-month follow-ups. All types of complications were systematically recorded.
Despite 52% of patients receiving anticoagulant therapy before surgery, we reported only 3% with haemorrhagic complications, no blood transfusion, a mean catheterization time of 44 h and a mean postoperative stay of 2.9 nights. No significant change in irrigation time, catheter time or hospital stay was observed in patients with or without anticoagulant therapy. The IPSS and bother scores significantly decreased after the 3-month follow-up (57% and 59%, respectively), but the average remaining prostate volume was 29 cc and the tissue ablation rate was only 0.5 cc/min. Three major complications occurred, consisting of two urinary fistulas and one partial bladder coagulation.
The TUVis procedure has a proven fast postoperative recovery time, good short-term functional outcome and good haemostatic efficiency. However, the tissue ablation rate was lower than expected and we encountered three major complications, the mechanisms of which remain unclear. Considering the high energy level required to create the plasma effect, the generator, cable and resectoscope must be carefully checked before each procedure.
研究类型 - 治疗（多中心队列）。证据水平 2b。
在多中心研究中评估经尿道前列腺等离子汽化术（TUVis）的早期功能结果。
在八个泌尿科进行了一项前瞻性多中心观察性研究。纳入标准为需要手术治疗的良性前列腺增生症（BPH）。接受抗凝治疗的患者不排除在外。根据制造商的建议，按照经典经尿道前列腺切除术（TURP）方案进行 TUVis 手术。我们使用自我问卷（国际前列腺症状评分[IPSS]和五分量表国际勃起功能指数[IIEF-5]）和客观标准（前列腺体积、前列腺特异性抗原[PSA]、尿流率、残余尿量）评估主观功能结果，基线和 1 个月和 3 个月随访。系统记录所有类型的并发症。
尽管 52%的患者在手术前接受抗凝治疗，但我们仅报告了 3%的出血并发症，无输血，平均导尿管时间为 44 小时，平均术后住院时间为 2.9 晚。有或没有抗凝治疗的患者，冲洗时间、导尿管时间或住院时间没有明显变化。在 3 个月随访后，IPSS 和困扰评分显著降低（分别为 57%和 59%），但平均剩余前列腺体积为 29 立方厘米，组织消融率仅为 0.5 立方厘米/分钟。发生了三个主要并发症，包括两个尿瘘和一个部分膀胱凝固。
TUVis 手术具有快速的术后恢复时间、良好的短期功能结果和良好的止血效果。然而，组织消融率低于预期，我们遇到了三个主要并发症，其机制尚不清楚。考虑到产生等离子体效应所需的高能量水平，在每次手术前必须仔细检查发生器、电缆和电切镜。
