Department of Urology, Kent and Canterbury Hospital, Canterbury, United Kingdom.
J Endourol. 2012 Jul;26(7):878-83. doi: 10.1089/end.2011.0370. Epub 2012 Feb 24.
The 80-W potassium-titanyl-phosphate (KTP) laser photoselective vaporization of the prostate (PVP) is a minimally invasive surgical option for patients with symptomatic benign prostatic hyperplasia, although evidence of long-term efficacy is limited. We present the long-term outcomes from a heterogeneous patient population.
We prospectively collected data for all patients who underwent 80-W KTP laser PVP treatment between 2004 and 2005. Evaluation occurred pr-operatively, and then at 3, 6, 12, and 60 months postoperatively. This included International Prostate Symptom Score (IPSS), peak urinary flow rate (Qmax), postvoid residual (PVR) volume, serum prostate-specific antigen measurement, and transrectal ultrasonography-estimated prostate volume.
A total of 115 patients were eligible for analysis, with a mean age of 77 years and mean prostate volume of 55.8 cc. Of these, 74% were operated on for lower urinary tract symptoms, 23% for acute urinary retention, and 3% for chronic retention; 30% of patients were American Society of Anesthesiologists score ≥ 3, and 93% were treated as 23-hour stays. No patients needed blood transfusion, and there were no cases of transurethral resection syndrome. An initial trial-without catheter failed in 11 (9.6%), although 8 of these successfully voided after a further week. At 5-year follow-up, mean Qmax improved from 8.0 ± 5.0 mL to 13.9 ± 7.7 mL and mean IPSS improved from 22 ± 5 to 9 ± 7. There were no cases of urethral strictures, but there was a 3.3% rate of bladder neck stenosis and an overall re-treatment rate of 21% over 5 years.
We confirm the long-term durability of the 80-W KTP laser PVP with minimal perioperative morbidity. It is therefore a safe option for high-risk patients with medical comorbidities, although its high reoperation rate may limit its use to this specific patient population.
80W 钾钛宝石（KTP）激光前列腺选择性汽化术（PVP）是治疗有症状的良性前列腺增生患者的一种微创选择，尽管其长期疗效的证据有限。我们展示了来自异质患者群体的长期结果。
我们前瞻性地收集了 2004 年至 2005 年间接受 80W KTP 激光 PVP 治疗的所有患者的数据。评估在术前进行，并在术后 3、6、12 和 60 个月进行。这包括国际前列腺症状评分（IPSS）、最大尿流率（Qmax）、残余尿量（PVR）、前列腺特异性抗原测定和经直肠超声估计的前列腺体积。
共有 115 名患者符合分析条件，平均年龄 77 岁，平均前列腺体积为 55.8cc。其中，74%因下尿路症状而接受手术，23%因急性尿潴留，3%因慢性潴留；30%的患者美国麻醉医师协会评分≥3，93%为 23 小时住院。没有患者需要输血，也没有发生经尿道切除综合征。11 例（9.6%）初始无导尿管试验失败，其中 8 例在进一步 1 周后成功排尿。在 5 年随访时，平均 Qmax 从 8.0±5.0mL 提高到 13.9±7.7mL，平均 IPSS 从 22±5 提高到 9±7。没有尿道狭窄的病例，但膀胱颈狭窄的发生率为 3.3%，5 年内总的再治疗率为 21%。
我们证实了 80W KTP 激光 PVP 的长期耐久性，其围手术期发病率低。因此，对于有合并症的高危患者，这是一种安全的选择，尽管其高再手术率可能限制其在这一特定患者群体中的使用。
