Department of Urology, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, 600 Yishan Road, Shanghai, China.
J Endourol. 2012 Oct;26(10):1314-8. doi: 10.1089/end.2011.0675. Epub 2012 Sep 11.
The study in China is the first on photoselective vaporization of the prostate (PVP) applied to bladder outlet obstruction (BOO) or urinary retention from advanced-stage prostate cancer (PCa). The aim is to evaluate the efficacy and safety of PVP in the treatment of patients with BOO secondary to advanced-stage PCa.
Forty-five patients (mean age 76.13±5.88 years, range 62-89 years) with BOO or urinary retention secondary to advanced-stage PCa received PVP with a potassium-titanyl-phosphate laser. The treatment outcome was evaluated with subjective and objective tests at 1, 3, 6, and 12 months after PVP using the International Prostate Symptom Score (IPSS), quality of life (QoL) score, postvoid residual (PVR) urine volume, and maximum urinary flow rate (Qmax). The operative time, indwelling catheterization time, and operative complications were also observed.
All 45 patients recovered without incident. The mean operative time was 50±7.6 minutes. The catheterization duration was 3.2 days (range 2-7 days). There was significant improvement in Qmax from 7.29±0.93 to 12.16±2.75 mL/sec after treatment at 12 months. Mean PVR volume decreased from 210.94±179.49 to 54.45±33.16 mL. Mean IPSS score decreased from preoperative 28.19±3.64 to postoperative 14.61±2.81 (P<0.05), QoL score decreased from 5.03±0.69 to 3.66±0.65 (P<0.05). There were no intraoperative adverse events. Postoperative complications included mild transient hematuria in 12 (26.7%) patients and mild dysuria in 11 (24.4%) patients within 4 weeks.
The clinical results suggest that PVP is a safe, efficient, and less-invasive treatment for patients with BOO or urinary retention secondary to advanced-stage PCa.
本研究是中国首例针对晚期前列腺癌（PCa）导致的膀胱出口梗阻（BOO）或尿潴留患者应用经尿道选择性前列腺汽化术（PVP）的研究。目的是评估 PVP 治疗晚期 PCa 导致的 BOO 患者的疗效和安全性。
45 例（平均年龄 76.13±5.88 岁，范围 62-89 岁）因晚期 PCa 导致 BOO 或尿潴留的患者接受了磷酸钛钾激光的 PVP 治疗。使用国际前列腺症状评分（IPSS）、生活质量评分（QoL）、残余尿量（PVR）和最大尿流率（Qmax）在 PVP 后 1、3、6 和 12 个月进行主观和客观评估，以评估治疗效果。还观察了手术时间、留置导尿时间和手术并发症。
所有 45 例患者均无意外恢复。平均手术时间为 50±7.6 分钟。导管插入时间为 3.2 天（范围 2-7 天）。治疗后 12 个月时，Qmax 从 7.29±0.93 显著增加至 12.16±2.75 mL/sec。平均 PVR 体积从 210.94±179.49 减少至 54.45±33.16 mL。平均 IPSS 评分从术前 28.19±3.64 降低至术后 14.61±2.81（P<0.05），QoL 评分从 5.03±0.69 降低至 3.66±0.65（P<0.05）。术中无不良事件发生。术后并发症包括 12 例（26.7%）患者出现轻度短暂性血尿和 11 例（24.4%）患者出现轻度排尿困难，均在 4 周内出现。
临床结果表明，PVP 是一种安全、有效、微创的治疗晚期 PCa 导致的 BOO 或尿潴留患者的方法。
