Urology, King's College Hospital, London, UKUrology, NUI Galway, Galway, Ireland.
BJU Int. 2011 Mar;107(5):772-776. doi: 10.1111/j.1464-410X.2010.09584.x. Epub 2010 Nov 5.
• To present our experience on photoselective vaporization of the prostate (PVP) in a cohort of men with bladder outlet obstruction (BOO) by prostate cancer.
• From 2003 to 2008 we identified 43 patients with prostate cancer treated with PVP. • The patients' hospital records were comprehensively reviewed to obtain preoperative, intra-operative and postoperative data. • Inclusion criteria were patients with BOO or urinary retention with a diagnosis of prostate cancer.
• Mean operating time was 42 min, mean post-operative hospital stay was 9.6 h. 32 out of 43 patients were discharged home within 24 h. Twelve patients (28%) did not need post-operative catheter. Mean and median catheter times were 22 and 21.5 h respectively. • Complications were mild: 1 patient needed bladder irrigation, 3 failed initial TWOC, 1 had early stress incontinence. Three had clot retention. • At 3 months post-operatively, 41 of 42 evaluable patients were voiding without a catheter. The mean peak flow rate had increased by 80% and a mean residual volume decreased of 49%. • Four patients underwent a second laser treatment. Three had developed further retention between 7 and 23 months post-operatively and did not want further surgery. The local failure rate at a mean follow up of 22 months was 7 of 39 patients (18%).
• The present study is the first on PVP applied to patients with prostate cancer. • It is shown that, for patients with CaP bothered by LUTS or retention, GreenLight laser prostatectomy is very safe and gives excellent relief from symptoms, with a good improvement in peak flow rate.
介绍我们在一组因前列腺癌导致膀胱出口梗阻（BOO）的患者中应用经尿道选择性前列腺汽化术（PVP）的经验。
2003 年至 2008 年，我们共确定了 43 例接受 PVP 治疗的前列腺癌患者。全面回顾了患者的住院记录，以获取术前、术中及术后数据。纳入标准为患有 BOO 或因前列腺癌而出现尿潴留的患者。
平均手术时间为 42 分钟，平均术后住院时间为 9.6 小时。43 例患者中有 32 例在 24 小时内出院回家。12 例（28%）患者无需术后导尿管。平均和中位数导管时间分别为 22 小时和 21.5 小时。并发症轻微：1 例患者需要膀胱冲洗，3 例初始 TWOC 失败，1 例早期出现压力性尿失禁，3 例出现血块滞留。术后 3 个月，42 例可评估患者中有 41 例无需导尿管排尿。平均最大尿流率增加了 80%，平均残余尿量减少了 49%。4 例患者接受了第二次激光治疗。3 例患者在术后 7 至 23 个月出现进一步的尿潴留，不想再进行手术。平均随访 22 个月时，39 例患者中有 7 例（18%）出现局部复发。
本研究是首例将 PVP 应用于前列腺癌患者的研究。结果表明，对于因 LUTS 或尿潴留而困扰的前列腺癌患者，绿光激光前列腺切除术非常安全，能显著缓解症状，最大尿流率有明显改善。
