Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
World J Mens Health. 2012 Dec;30(3):160-5. doi: 10.5534/wjmh.2012.30.3.160. Epub 2012 Dec 27.
There is little data evaluating the changes of severity of bladder outlet obstruction after 80 W-potassium-titanyl-phosphate (KTP) photoselective laser vaporization prostatectomy (PVP) by pressure-flow study. We evaluated the efficacy of PVP to relieve the obstruction in benign prostate hyperplasia (BPH) compared with transurethral resection of the prostate (TURP).
This is a prospective, non-randomized single center study. The inclusion criteria were as follows: Men suffering from lower urinary tract symptoms (LUTS) secondary to BPH, age ≥50 years, International Prostatic Symptom Score (IPSS) ≥13, maximum flow rate (Qmax) ≤15 ml/s, and ability to give fully informed consent. Patients with neurogenic cause or detrusor underactivity were excluded. The IPSS, bother score, Qmax, postvoid residual volume (PVR), detrusor pressure at maximum flow rate (PdetQmax), bladder outlet obstruction index (BOOI), and prostate volume were measured before and 6 months after surgery and compared between PVP and TURP.
Sixty-seven patients (53 in PVP, 14 in TURP) were evaluable. In both groups, the IPSS, bother score, Qmax, and PVR had significantly improved (p<0.05), and there were no differences between the changes in those parameters. PVP could effectively reduce the PdetQmax, prostate volume, and BOOI from baseline (from 68.7±23.3 to 40.6±11.2 cmH2O, 49.5±16.3 to 31.3±12.1 ml, 49.8±25.6 to 9.8±20.7), similar to TURP. There were no differences in postoperative PdetQmax, prostate volume, or BOOI between the two groups. The percentage of patients with BOOI ≥40 was decreased from 64% to 4% in the PVP group and from 86% to 14% in the TURP group.
PVP could reduce the prostate volume effectively and relieve bladder outlet obstruction similar to TURP by the 6-month follow up in men with BPH.
通过压力-流率研究评估 80W 钬钛钾-磷酸盐（KTP）光选择性前列腺切除术（PVP）后膀胱出口梗阻严重程度的变化数据很少。我们评估了 PVP 与经尿道前列腺切除术（TURP）相比，在缓解良性前列腺增生（BPH）引起的梗阻方面的疗效。
这是一项前瞻性、非随机的单中心研究。纳入标准如下：患有下尿路症状（LUTS）的男性，年龄≥50 岁，国际前列腺症状评分（IPSS）≥13，最大尿流率（Qmax）≤15ml/s，有完全知情同意的能力。排除神经源性原因或逼尿肌无力的患者。在手术前和手术后 6 个月测量 IPSS、烦恼评分、Qmax、剩余尿量（PVR）、最大尿流率时逼尿肌压力（PdetQmax）、膀胱出口梗阻指数（BOOI）和前列腺体积，并比较 PVP 和 TURP 之间的差异。
67 例患者（PVP 组 53 例，TURP 组 14 例）可评估。在两组中，IPSS、烦恼评分、Qmax 和 PVR 均显著改善（p<0.05），且这些参数的变化无差异。PVP 能有效降低从基线开始的 PdetQmax、前列腺体积和 BOOI（从 68.7±23.3 降至 40.6±11.2cmH2O，从 49.5±16.3 降至 31.3±12.1ml，从 49.8±25.6 降至 9.8±20.7），与 TURP 相似。两组间术后 PdetQmax、前列腺体积或 BOOI 无差异。PVP 组 BOOI≥40%的患者比例从 64%降至 4%，TURP 组从 86%降至 14%。
在 BPH 男性中，PVP 在 6 个月随访时可有效降低前列腺体积，并通过降低 BOOI 来缓解膀胱出口梗阻，与 TURP 相似。
