Kim Joon Woo, Kim Yeon Joo, Lee Yoon Hyung, Kwon Joon Beom, Cho Sung Ryong, Kim Jae Soo
Department of Urology, Daegu Fatima Hospital, Daegu, Korea.
Korean J Urol. 2014 Jan;55(1):41-6. doi: 10.4111/kju.2014.55.1.41. Epub 2014 Jan 15.
In recent years, laser surgery has been widely used to treat benign prostatic hyperplasia (BPH). A thulium:yttrium-aluminium-garnet (Tm:YAG) laser was recently introduced for BPH surgery. We compared the effectiveness and safety of Tm:YAG laser vaporesection of the prostate (ThuVaRP) with that of bipolar transurethral resection of the prostate (TURP).
From January 2010 to December 2012, 86 patients underwent surgical treatment for symptomatic BPH by a single surgeon. We retrospectively analyzed and compared the medical records of 43 patients who underwent ThuVaRP and 43 patients who underwent bipolar TURP. All patients were assessed by using the International Prostate Symptom Score, transrectal ultrasonography, the serum prostate-specific antigen (PSA) level, uroflowmetry, and postvoid residual volume before and 1 month after surgery. All complications were compared between the two groups.
ThuVaRP was superior to TURP in catheterization time (p<0.001) and length of hospital stay (p<0.001). However, operation time was longer with ThuVaRP than with TURP (p<0.001). In patients with a large prostate (>50 g), operation time was much longer with ThuVaRP. One month after surgery, the decrease in PSA was greater (p=0.045) with ThuVaRP than with TURP, and the increase in maximal urine flow rate was greater (p<0.001) with ThuVaRP than with TURP. The postoperative complication transient urinary incontinence was significantly different between the ThuVaRP group (nine cases, 20.9%) and the TURP group (two cases, 4.7%). Other complications were comparable between groups.
The effectiveness and safety of ThuVaRP and TURP were comparable. ThuVaRP is a promising alternative surgical technique to TURP for BPH.
近年来，激光手术已广泛应用于治疗良性前列腺增生（BPH）。一种铥：钇铝石榴石（Tm：YAG）激光最近被引入用于BPH手术。我们比较了前列腺铥激光汽化切除术（ThuVaRP）与双极经尿道前列腺切除术（TURP）的有效性和安全性。
2010年1月至2012年12月，86例有症状的BPH患者由同一位外科医生进行手术治疗。我们回顾性分析并比较了43例行ThuVaRP手术的患者和43例行双极TURP手术的患者的病历。所有患者在手术前及术后1个月均通过国际前列腺症状评分、经直肠超声检查、血清前列腺特异性抗原（PSA）水平、尿流率测定和残余尿量进行评估。比较两组之间的所有并发症。
ThuVaRP在导尿时间（p<0.001）和住院时间（p<0.001）方面优于TURP。然而，ThuVaRP的手术时间比TURP长（p<0.001）。对于前列腺较大（>50 g）的患者，ThuVaRP的手术时间长得多。术后1个月，ThuVaRP组的PSA下降幅度大于TURP组（p=0.045），最大尿流率增加幅度大于TURP组（p<0.001）。ThuVaRP组（9例，20.9%）和TURP组（2例，4.7%）术后短暂性尿失禁并发症有显著差异。两组之间的其他并发症相当。
ThuVaRP和TURP的有效性和安全性相当。ThuVaRP是一种有前途的替代TURP治疗BPH的手术技术。
