Vasudeva Pawan, Kumar Niraj, Kumar Anup, Kumar Gaurav, Patel Mikir, Gupta Pankaj
Department of Urology and Renal Transplant, V.M. Medical College and Safdarjang Hospital, New Delhi, India.
Low Urin Tract Symptoms. 2019 Jan;11(1):24-29. doi: 10.1111/luts.12189. Epub 2017 Aug 1.
To compare monopolar transurethral resection of the prostate (TURP), bipolar TURP and photoselective vaporization of the prostate (PVP) by 120-W GreenLight laser with regard to the impact on International Index of Erectile Function (IIEF)-5 score in patients presenting with lower urinary tract symptoms (LUTS) secondary to prostate >80 mL.
Between April 2012 and March 2015, 110 patients who satisfied eligibility criteria were divided into three groups according to surgical modality adopted to treat benign prostatic enlargement. Preoperative, perioperative, and follow-up data were collected. The three groups were as follows: group A, monopolar TURP; group B, bipolar TURP; and group C, PVP.
The baseline characteristics of the three groups were similar. All the perioperative parameters were significantly favorable in group C compared with the other two groups, except for mean operative time, which was significantly higher in group C. International Prostate Symptom Score, postvoid residual urine, maximum flow rate and quality of life score had significant and similar improvement during follow up in all three groups. Also, prostate volume reduced significantly in all three groups following surgery, but it remained significantly higher in group C patients compared with groups A and B. Mean IIEF-5 score was similar between the three groups at baseline and during each of the follow-up visits. Groups A, B and C had declines of 3.27% (P = 0.34), 2.68% (P = 0.40) and 3.36% (P = 0.35), respectively, in mean IIEF-5 score at 12-month follow up compared with baseline.
Monopolar TURP, bipolar TURP and PVP by 120-W GreenLight laser for prostate size >80 mL do not have a significant impact on IIEF-5 score at 12-month follow up.
比较经尿道前列腺单极电切术(TURP)、双极TURP以及120W绿激光前列腺选择性汽化术(PVP)对前列腺体积>80mL且伴有下尿路症状(LUTS)患者国际勃起功能指数(IIEF)-5评分的影响。
2012年4月至2015年3月期间,110例符合入选标准的患者根据治疗良性前列腺增生所采用的手术方式分为三组。收集术前、围手术期及随访数据。三组如下:A组,单极TURP;B组,双极TURP;C组,PVP。
三组的基线特征相似。与其他两组相比,C组所有围手术期参数均明显更优,但平均手术时间除外,C组的平均手术时间明显更长。三组患者在随访期间国际前列腺症状评分、残余尿量、最大尿流率及生活质量评分均有显著且相似的改善。此外,三组患者术后前列腺体积均显著减小,但C组患者的前列腺体积仍显著高于A组和B组。三组在基线时及每次随访时的平均IIEF-5评分相似。与基线相比,A组、B组和C组在12个月随访时的平均IIEF-5评分分别下降了3.27%(P = 0.34)、2.68%(P = 0.40)和3.36%(P = 0.35)。
对于前列腺体积>80mL的患者,经尿道前列腺单极电切术、双极TURP以及120W绿激光PVP在12个月随访时对IIEF-5评分无显著影响。