Department of Urology, Tauranga Hospital, New Zealand.
BJU Int. 2012 Feb;109(3):408-11. doi: 10.1111/j.1464-410X.2011.10359.x. Epub 2011 Aug 23.
To assess the durability of holmium laser enucleation of prostate in comparison to transurethral resection of the prostate (TURP).
Patients were enrolled in the present study between June 1997 and December 2000 and followed per protocol. All patients were urodynamically obstructed with a prostate volume of between 40 and 200 mL. At long-term follow-up, variables assessed included Benign Prostatic Hyperplasia Impact Index (BPHII), International Continence Society Short Form Male questionnaire (ICSmale-SF) and the International Index of Erectile Function (IIEF). Adverse events, including the need for retreatment, were specifically assessed.
Thirty-one (14 holmium laser enucleation of the prostate [HoLEP] and 17 TURP) of the initial 61 patients were available, with 12 deceased and 18 lost to follow-up. The mean (range) follow-up was 7.6 (5.9-10.0) years and the mean (±sd) age at follow-up was 79.8 (±6.2) years. The mean (±sd) values (HoLEP vs TURP) were as follows: maximum urinary flow rate (Q(max)), 22.09 ± 15.47 vs 17.83 ± 8.61 mL/s; American Urological Association (AUA) symptom score, 8.0 ± 5.2 vs 10.3 ± 7.42; quality of life (QOL) score 1.47 ± 1.31 vs 1.31 ± 0.85; BPHII, 1.53 ± 2.9 vs 0.58 ± 0.79; IIEF-EF (erectile function), 11.6 ± 7.46 vs 9.21 ± 7.17; ICSmale Voiding Score (VS), 4.2 ± 3.76 vs 3.0 ± 2.41; ICSmale Incontinence Score (IS), 3.07 ± 3.3 vs 1.17 ± 1.4. There were no significant differences in any variable between the two groups beyond the first year. Of the assessable patients, none required re-operation for recurrent BPH in the HoLEP arm and three (of 17) required re-operation in the TURP arm .
The results of this randomized trial confirm that HoLEP is at least equivalent to TURP in the long term with fewer re-operations being necessary.
评估钬激光前列腺剜除术与经尿道前列腺切除术（TURP）相比的耐久性。
本研究纳入的患者于 1997 年 6 月至 2000 年 12 月间入组，并按方案进行随访。所有患者均存在逼尿肌梗阻，前列腺体积为 40-200ml。在长期随访中，评估的变量包括良性前列腺增生影响指数（BPHII）、国际尿控协会短问卷男性版（ICSmale-SF）和国际勃起功能指数（IIEF）。特别评估了不良事件，包括需要再次治疗的情况。
61 例患者中有 31 例（14 例接受钬激光前列腺剜除术[HoLEP]，17 例接受 TURP）可进行评估，12 例死亡，18 例失访。平均（范围）随访时间为 7.6（5.9-10.0）年，随访时的平均（±标准差）年龄为 79.8（±6.2）岁。HoLEP 与 TURP 的平均值（±标准差）如下：最大尿流率（Qmax），22.09±15.47 比 17.83±8.61ml/s；美国泌尿外科学会（AUA）症状评分，8.0±5.2 比 10.3±7.42；生活质量（QOL）评分，1.47±1.31 比 1.31±0.85；BPHII，1.53±2.9 比 0.58±0.79；IIEF-EF（勃起功能），11.6±7.46 比 9.21±7.17；ICSmale 排尿评分（VS），4.2±3.76 比 3.0±2.41；ICSmale 尿失禁评分（IS），3.07±3.3 比 1.17±1.4。两组患者在第一年以后的任何变量均无显著差异。在可评估的患者中，HoLEP 组无一例因复发性 BPH 需要再次手术，而 TURP 组有 3 例（17 例）需要再次手术。
这项随机试验的结果证实，与 TURP 相比，HoLEP 在长期内至少同样有效，需要再次手术的病例更少。
