Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany.
Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany.
Urology. 2014 Jan;83(1):175-80. doi: 10.1016/j.urology.2013.08.029. Epub 2013 Oct 5.
To evaluate changes in erectile function after thulium VapoEnucleation of the prostate (ThuVEP) for the treatment of benign prostatic obstruction at 12-month follow-up.
We prospectively evaluated 72 patients who underwent ThuVEP between January and July 2011. Preoperative evaluation included maximum urinary flow rate (Qmax), international prostate symptom score (IPSS), quality of life (QoL), postvoiding residual urine (PVR), and the Erectile function domain of the International Index of Erectile Function (IIEF-EF). According to preoperative IIEF-EF score, patients were classified into subgroup A (IIEF-EF ≥19, n = 38) and subgroup B (IIEF-EF <19, n = 34). All complications during the perioperative period were noted and classified according to the modified Clavien classification system. All patients were reassessed at 12-month follow-up by Qmax, IPSS, QoL, PVR, and IIEF-EF score. Patient data were expressed as median (interquartile range).
Median patient age was 70 (65-73) years, and the median prostate volume was 52.5 (39.75-72) mL, respectively. At 12-month follow-up, IPSS (20 vs 4), QoL (4 vs 1), Qmax (9.7 vs 22.15 mL/s), and PVR (100 vs 15 mL) improved significantly in comparison with preoperative assessment (P ≤.001) without differences between subgroup A and B. A slight but not statistically significant increase of the IIEF-EF domain score was reported at 12-month follow-up (19.5 vs 20), which could be shown in subgroup A (25 vs 26) and B (6 vs 8).
ThuVEP is a safe and effective procedure for the treatment of benign prostatic obstruction. At 12-month follow-up, marginal nonsignificant erectile function improvement was reported after surgery.
评估经尿道铥激光前列腺剜除术（ThuVEP）治疗良性前列腺梗阻后 12 个月时勃起功能的变化。
我们前瞻性评估了 2011 年 1 月至 7 月期间接受 ThuVEP 的 72 例患者。术前评估包括最大尿流率（Qmax）、国际前列腺症状评分（IPSS）、生活质量（QoL）、残余尿量（PVR）和国际勃起功能指数（IIEF-EF）的勃起功能域。根据术前 IIEF-EF 评分，患者分为亚组 A（IIEF-EF≥19，n=38）和亚组 B（IIEF-EF<19，n=34）。记录围手术期的所有并发症，并根据改良 Clavien 分类系统进行分类。所有患者均在 12 个月时通过 Qmax、IPSS、QoL、PVR 和 IIEF-EF 评分进行重新评估。患者数据表示为中位数（四分位距）。
中位患者年龄为 70（65-73）岁，前列腺体积中位数为 52.5（39.75-72）mL。在 12 个月时，与术前评估相比，IPSS（20 分比 4 分）、QoL（4 分比 1 分）、Qmax（9.7 分比 22.15mL/s）和 PVR（100 分比 15 分）均显著改善（P≤.001），但亚组 A 和 B 之间无差异。在 12 个月时，IIEF-EF 域评分略有但无统计学意义的升高（19.5 分比 20 分），在亚组 A（25 分比 26 分）和 B（6 分比 8 分）中可观察到。
ThuVEP 是治疗良性前列腺梗阻的一种安全有效的方法。在 12 个月时，手术后报告勃起功能有轻微但无统计学意义的改善。
