Lee Young Ju, Oh Shin Ah, Kim Sung Han, Oh Seung-June
Department of Urology, Seoul National University Hospital, Seoul, South Korea.
Department of Urology, Prostate Cancer Center, Research Institute and National Cancer Center, Goyang, South Korea.
PLoS One. 2017 Aug 9;12(8):e0182230. doi: 10.1371/journal.pone.0182230. eCollection 2017.
To investigate patient satisfaction after holmium laser enucleation of the prostate (HoLEP) in a prospective study.
From May 2012 to December 2014, 397 patients underwent HoLEP by a single surgeon and enrolled in our prospective registry. Baseline data included age, PSA, transrectal ultrasonography, the international prostate symptom score (IPSS), and overactive bladder symptom score (OABSS). Subjective assessment of surgical outcomes was performed at 6 months postoperatively using self-administered questionnaires consisting of 'satisfaction with treatment question' (STQ), 'overall response assessment' (ORA), and 'willingness to undergo surgery question' (WSQ).
A total of 331 patients (mean age 69.6±7.0 years) were included in the analysis. Mean total prostate volume was 69.5 (±42.2) ml. Mean preoperative IPSS score was 18.5 (±7.8). The STQ showed that most patients (91.8%) were satisfied after the surgery. Only 11 (3.3%) patients responded with 'dissatisfied', and no patients replied with 'very dissatisfied'. The WSQ showed that 311 (94.0%) patients were willing to undergo the surgery again if they had to reconsider the surgical decision. The ORA showed that all patients (99.4%) experienced an improvement. When compared with satisfied patients, neutral/dissatisfied patients had lower IPSS quality of life scores (2.7 vs. 0.9, p<0.001), higher IPSS voiding symptom scores (7.0 vs. 1.4, p<0.001), and more frequent episodes of urgency urinary incontinence in OABSS (1.0 vs. 0.3, p = 0.017) at 6 months postoperatively.
The overall level of satisfaction after HoLEP was high. The most common reason for dissatisfaction was the occurrence of urgency urinary incontinence after the surgery.
在一项前瞻性研究中调查钬激光前列腺剜除术（HoLEP）后患者的满意度。
2012年5月至2014年12月，397例患者由同一位外科医生实施HoLEP手术并纳入我们的前瞻性登记研究。基线数据包括年龄、前列腺特异抗原（PSA）、经直肠超声检查、国际前列腺症状评分（IPSS）和膀胱过度活动症症状评分（OABSS）。术后6个月使用由“治疗满意度问题”（STQ）、“总体反应评估”（ORA）和“是否愿意再次接受手术问题”（WSQ）组成的自填问卷对手术结果进行主观评估。
共有331例患者（平均年龄69.6±7.0岁）纳入分析。平均前列腺总体积为69.5（±42.2）ml。术前平均IPSS评分为18.5（±7.8）。STQ显示大多数患者（91.8%）术后感到满意。只有11例（3.3%）患者回答“不满意”，没有患者回答“非常不满意”。WSQ显示311例（94.0%）患者表示如果必须重新考虑手术决定，愿意再次接受该手术。ORA显示所有患者（99.4%）病情均有改善。与满意的患者相比，中立/不满意的患者术后6个月时IPSS生活质量评分较低（2.7对0.9，p<0.001），IPSS排尿症状评分较高（7.0对1.4，p<0.001），且OABSS中急迫性尿失禁发作更频繁（1.0对0.3，p = 0.017）。
HoLEP术后总体满意度较高。最常见的不满意原因是术后出现急迫性尿失禁。
