Sohn Jun Ho, Choi Yong Sun, Kim Su Jin, Cho Hyuk Jin, Hong Sung Hoo, Lee Ji Youl, Hwang Tae-Kon, Kim Sae Woong
Department of Urology, The Catholic University of Korea, School of Medicine, Seoul, Korea.
Korean J Urol. 2011 Mar;52(3):178-83. doi: 10.4111/kju.2011.52.3.178. Epub 2011 Mar 18.
To examine the effectiveness and safety of photoselective vaporization of the prostate (PVP) with the 120 W high-performance system (HPS) Greenlight laser procedure in benign prostatic hyperplasia (BPH) patients taking oral anticoagulant medications.
This study was conducted on BPH patients taking oral anticoagulant medications form March 2009 to December 2010. Group I consisted of patients who stopped oral anticoagulant medications before surgery (n=30), and group II consisted of patients who continued oral anticoagulant medications before surgery (n=30). PVP applying the 120 W HPS Greenlight laser was done, and followed up for 12 weeks. Follow-up variables were International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), postvoid residual urine volume (PVR), and hemoglobin level change.
At 12 weeks after surgery, we confirmed the improvement in the IPSS score of Group I compared with preoperative scores. The quality of life (QoL) score, Qmax and PVR were also improved. respectively, both of which were significantly improved. In Group II, similarly, the total IPSS score, the voiding symptom score, and the storage symptom score were improved in comparison with the preoperative scores. The QoL score, Qmax and the PVR were improved in comparison with the preoperative scores. During the 12-week follow-up period, no major postsurgical complications requiring transfusion, rehospitalization, etc. were observed.
The 120 W HPS Greenlight laser PVP procedure can be performed effectively and safely in BPH patients, even those who cannot stop oral anticoagulant medications despite requiring surgery.
探讨采用120W高性能系统(HPS)绿激光前列腺选择性汽化术治疗服用口服抗凝药的良性前列腺增生(BPH)患者的有效性和安全性。
本研究针对2009年3月至2010年12月期间服用口服抗凝药的BPH患者开展。第一组由术前停用口服抗凝药的患者组成(n = 30),第二组由术前继续服用口服抗凝药的患者组成(n = 30)。采用120W HPS绿激光进行前列腺选择性汽化术,并随访12周。随访变量包括国际前列腺症状评分(IPSS)、最大尿流率(Qmax)、残余尿量(PVR)和血红蛋白水平变化。
术后12周,我们确认第一组的IPSS评分较术前有所改善。生活质量(QoL)评分、Qmax和PVR也分别得到改善,且均有显著提高。同样,在第二组中,与术前评分相比,总IPSS评分、排尿症状评分和储尿症状评分均有所改善。与术前评分相比,QoL评分、Qmax和PVR也有所改善。在12周的随访期内,未观察到需要输血、再次住院等重大术后并发症。
120W HPS绿激光前列腺选择性汽化术在BPH患者中可有效、安全地进行,即使是那些尽管需要手术但无法停用口服抗凝药的患者。