Kim Youngho, Seong Youl Keun, Kim In Gon, Han Bo Hyun
Department of Urology, Maryknoll Medical Center, Busan, Korea.
Korean J Urol. 2013 Oct;54(10):677-81. doi: 10.4111/kju.2013.54.10.677. Epub 2013 Oct 15.
This study was conducted with the use of 12 months of follow-up data to evaluate the efficacy of photoselective vaporization of the prostate (PVP) with the 980-nm diode laser for the treatment of symptomatic benign prostatic hyperplasia (BPH).
The clinical data of 84 men with symptomatic BPH who underwent PVP with the 980-nm K2 diode laser between March 2010 and October 2011 were retrospectively analyzed. Postoperative parameters, including International Prostate Symptom Score (IPSS), quality of life (QoL) score, maximum urinary flow rate (Qmax), and postvoid residual volume (PVR), were assessed and compared with preoperative baseline values.
Mean patient age was 72.4±6.5 years, and mean preoperative prostate volume was 47.2±16.3 g. Mean operative time was 23.3±19.1 minutes, and total amount of energy was 128±85 kJ. Mean catheterization time was 23.7±5.9 hours. At 1 month, significant improvements were noted in IPSS (11.5±6.8), QoL score (2.2±1.3), Qmax (12.9±6.5 mL/s), and PVR (41.2±31.3 mL). Three months after surgery, all postoperative follow-up parameters showed significant improvements, and the 6- and 12-month data showed sustained improvement of postoperative follow-up parameters. Bladder neck strictures were observed in 10.7% of the patients and urge incontinence in 16.6%.
PVP using a K2 diode laser is an effective procedure for the treatment of lower urinary tract symptoms secondary to BPH. PVP leads to an immediate and sustained improvement of subjective and objective voiding parameters. Surgeons should be vigilant for postoperative bladder neck stricture and urge incontinence.
本研究利用12个月的随访数据,评估980纳米二极管激光选择性前列腺汽化术(PVP)治疗有症状良性前列腺增生(BPH)的疗效。
回顾性分析2010年3月至2011年10月间84例有症状BPH患者接受980纳米K2二极管激光PVP手术的临床资料。评估术后参数,包括国际前列腺症状评分(IPSS)、生活质量(QoL)评分、最大尿流率(Qmax)和残余尿量(PVR),并与术前基线值进行比较。
患者平均年龄为72.4±6.5岁,术前平均前列腺体积为47.2±16.3克。平均手术时间为23.3±19.1分钟,总能量为128±85千焦。平均导尿时间为23.7±5.9小时。术后1个月,IPSS(11.5±6.8)、QoL评分(2.2±1.3)、Qmax(12.9±6.5毫升/秒)和PVR(41.2±31.3毫升)有显著改善。术后3个月,所有术后随访参数均有显著改善,6个月和12个月的数据显示术后随访参数持续改善。10.7%的患者出现膀胱颈狭窄,16.6%的患者出现急迫性尿失禁。
使用K2二极管激光的PVP是治疗BPH继发下尿路症状的有效方法。PVP可使主观和客观排尿参数立即并持续改善。外科医生应警惕术后膀胱颈狭窄和急迫性尿失禁。