Luo Fei, Sun Hong-Hong, Su Yan-Hui, Zhang Zhi-Hua, Wang Ya-Shen, Zhao Zhen, Li Jian
Department of Urology, Tianjin Union Medical Center, No. 190 Jie-yuan Road, Hong-qiao District, Tianjin, China.
Lasers Med Sci. 2017 May;32(4):895-901. doi: 10.1007/s10103-017-2190-1. Epub 2017 Mar 14.
The purpose of this study is to assess the safety and efficacy of GreenLight laser photoselective vaporization of the prostate (PVP) for the treatment of benign prostate hyperplasia/lower urinary tract symptoms (BPH/LUTS) in patients with different post-void residual urine (PVR). BPH/LUTS patients treated with PVP from January 2014 to January 2016 were enrolled in the present study. All patients were divided into PVR > 50, 50 ≤ PVR < 400, and PVR ≥ 400 ml groups, and standard general and urological methods for BPH/LUTS were carried out. PVP surgery was performed, and the follow-up outcome was investigated 6 months after surgery. A total of 429 patients were included, and there were no significant differences in comorbid diseases or habits among the three groups. The maximum urinary flow rate (Qmax) differed significantly among the groups (P < 0.001), while patients in the PVR < 50 ml group had higher maximum detrusor pressure (Pdet.max) level than the other two groups (P < 0.001). Patients in 50 ≤ PVR < 400 (P < 0.001) and PVR ≥ 400 (P < 0.001) ml groups were more likely to develop detrusor underactivity than those in the PVR < 50 ml group. All patients were treated with PVP, and there were no severe complications requiring rehospitalization or reoperation except nine designed re-treatments. Follow-up data of 387 patients were available. Significant improvement in outcome parameters (International Prostate Symptom Score [IPSS], Qmax, and PVR) was observed in comparison with baseline measurements for the three groups. PVP significantly improved the IPSS, Qmax, and PVR in patients with different PVR; PVP is a safe and effective procedure for BPH/LUTS patients.
本研究旨在评估绿激光前列腺选择性汽化术(PVP)治疗不同残余尿量(PVR)的良性前列腺增生/下尿路症状(BPH/LUTS)患者的安全性和疗效。纳入2014年1月至2016年1月接受PVP治疗的BPH/LUTS患者。所有患者分为PVR>50、50≤PVR<400和PVR≥400 ml组,并采用BPH/LUTS的标准常规和泌尿外科方法进行治疗。进行PVP手术,并在术后6个月调查随访结果。共纳入429例患者,三组患者的合并疾病或习惯无显著差异。三组间最大尿流率(Qmax)差异有统计学意义(P<0.001),而PVR<50 ml组患者的最大逼尿肌压力(Pdet.max)水平高于其他两组(P<0.001)。与PVR<50 ml组相比,PVR为50≤PVR<400(P<0.001)和PVR≥400(P<0.001)ml组的患者更易发生逼尿肌活动减退。所有患者均接受PVP治疗,除9例计划再次治疗外,无严重并发症需要再次住院或再次手术。可获得387例患者的随访数据。与基线测量值相比,三组患者的结局参数(国际前列腺症状评分[IPSS]、Qmax和PVR)均有显著改善。PVP显著改善了不同PVR患者的IPSS、Qmax和PVR;PVP对于BPH/LUTS患者是一种安全有效的治疗方法。