Cho Sung Yong, Ro Yun Kwan, Kim Hwanik, Son Hwancheol
Department of Urology, Seoul National University College of Medicine, Seoul, Korea.; Department of Urology, SMG-SNU Boramae Medical Center, Seoul, Korea.
Department of Urology, Seoul National University College of Medicine, Seoul, Korea.
World J Mens Health. 2015 Dec;33(3):182-7. doi: 10.5534/wjmh.2015.33.3.182. Epub 2015 Dec 23.
The aim of the present study was to evaluate preoperative acute urinary retention (AUR) as a factor affecting the outcomes of patients who underwent photoselective vaporization of the prostate (PVP), both in terms of overall effectiveness and the postoperative incidence of AUR.
Baseline prostate characteristics were obtained for patients who underwent PVP, including prostate-specific antigen (PSA) levels, transrectal ultrasound findings, voiding diary parameters, the International Prostate Symptoms Score (IPSS), and uroflowmetry parameters. These parameters were assessed two weeks, one month, three months, six months, and three years postoperatively. Subjects were divided into AUR and non-AUR groups based on the preoperative occurrence of AUR.
Of the 476 patients, 91 had at least one episode of preoperative AUR. The AUR group was found to be significantly older and to have significantly higher PSA levels, lower body mass indices, and larger prostates. At one year of follow-up, the total IPSS was 7.6±6.8 in the AUR group and 11.4±8.2 in the non-AUR group, with the AUR group showing a more significant improvement. In the non-AUR group, 17 of the 385 patients (4.4%) experienced postoperative retention, compared to 16 of the 91 patients (17.6%) patients in the AUR group.
Almost all patients exhibited improvements in subjective and objective voiding parameters following PVP, regardless of the presence of preoperative urinary retention. Patients with a preoperative history of AUR had a higher risk of postoperative retention.
本研究的目的是评估术前急性尿潴留(AUR)作为影响接受前列腺光选择性汽化术(PVP)患者结局的一个因素,包括总体有效性和术后AUR的发生率。
获取接受PVP患者的基线前列腺特征,包括前列腺特异性抗原(PSA)水平、经直肠超声检查结果、排尿日记参数、国际前列腺症状评分(IPSS)和尿流率参数。在术后两周、一个月、三个月、六个月和三年对这些参数进行评估。根据术前是否发生AUR将受试者分为AUR组和非AUR组。
476例患者中,91例至少有一次术前AUR发作。发现AUR组年龄显著更大,PSA水平显著更高,体重指数更低,前列腺更大。随访一年时,AUR组的总IPSS为7.6±6.8,非AUR组为11.4±8.2,AUR组改善更显著。在非AUR组,385例患者中有17例(4.4%)出现术后尿潴留,而AUR组91例患者中有16例(17.6%)出现术后尿潴留。
无论术前是否存在尿潴留,几乎所有患者在PVP术后主观和客观排尿参数均有改善。有术前AUR病史的患者术后尿潴留风险更高。