Christidis Daniel, McGrath Shannon, Perera Marlon, Manning Todd, Bolton Damien, Lawrentschuk Nathan
Department of Surgery, University of Melbourne, Austin Health, Melbourne, Australia.
Young Urology Researchers Organization (YURO), Melbourne, Australia.
Prostate Int. 2017 Jun;5(2):41-46. doi: 10.1016/j.prnil.2017.01.007. Epub 2017 Jan 19.
The prevalence of benign prostatic hypertrophy (BPH) causing bothersome lower urinary tract symptoms increases with our ageing population. Treatment of BPH traditionally begins with medical therapy and surgical intervention is then considered for those whose symptoms progress despite treatment. Minimally invasive surgical therapies have been developed as an intermediary in the treatment of BPH with the aim of decreasing the invasiveness of interventions. These therapies also aim to reduce morbidity and dysfunction related to invasive surgical procedures. Multiple treatment options exist in this group including mechanical and thermo-ablative strategies. Emerging therapies utilizing differing technologies range from the established to the experimental. We review the current literature related to these minimally invasive therapies and the evidence of their effectiveness in treating BPH. The role of minimally invasive surgical therapies in the treatment of BPH is still yet to be strongly defined. Given the experimental nature of many of the modalities, further study is required prior to their recommendation as alternatives to invasive surgical therapy. More mature evidence is required for the analysis of durability of effect of these therapies to make robust conclusions of their effectiveness.
随着人口老龄化，引起令人困扰的下尿路症状的良性前列腺增生（BPH）患病率不断上升。BPH的治疗传统上始于药物治疗，对于那些尽管接受了治疗但症状仍进展的患者，则考虑进行手术干预。微创外科治疗已被开发出来作为BPH治疗的一种中间手段，目的是降低干预的侵入性。这些治疗还旨在减少与侵入性手术相关的发病率和功能障碍。这一组中有多种治疗选择，包括机械和热消融策略。利用不同技术的新兴疗法从已确立的到实验性的都有。我们回顾了与这些微创治疗相关的当前文献以及它们治疗BPH有效性的证据。微创外科治疗在BPH治疗中的作用仍有待明确界定。鉴于许多治疗方式的实验性质，在推荐它们作为侵入性手术治疗的替代方法之前，需要进一步研究。需要更成熟的证据来分析这些治疗效果的持久性，以便对其有效性得出可靠的结论。
