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经尿道前列腺切除术(TURP)与良性前列腺增生的绿激光选择性汽化术对比:随访1年后良性前列腺增生6项结果分析

Transurethral resection of the prostate (TURP) vs GreenLight photoselective vaporization of benign prostatic hyperplasia: analysis of BPH6 outcomes after 1 year of follow-up.

作者信息

Cimino S, Voce S, Palmieri F, Favilla V, Castelli T, Privitera S, Giardina R, Reale G, Russo G I, Morgia G

机构信息

Department of Surgery, Urology Section, University of Catania, Catania, Italy.

Urology Division, Lugo of Romagna Hospital, Ravenna, Italy.

出版信息

Int J Impot Res. 2017 Nov;29(6):240-243. doi: 10.1038/ijir.2017.30. Epub 2017 Aug 17.

DOI:10.1038/ijir.2017.30
PMID:28814812
Abstract

The surgical treatment of benign prostatic obstruction is changing over the time, thanks the increase evidence about the successful role of laser techniques in this surgery. We aimed to compare prostatic GreenLight photovaporization (PVP) to bipolar transurethral resection of the prostate (TURP) with regard to lower urinary tract symptoms (LUTS) improvement through the evaluation of BPH6. We enrolled 220 consecutive subjects affected by LUTS. We performed a propensity score matching using prostate volume, peak flow and International Prostate Symptoms Score (IPSS). A total of 110 (55 TURP and 55 PVP) were analyzed. We found after 1 year of follow-up that the rate of subjects resulting in greater BPH6 recovery in the PVP group vs TURP (45.6% vs 18.2%; P=0.001). The TURP treatment showed greater catheterization time (4.67 vs 1.25; P<0.01) while PVP showed greater recovery experience (82.4 vs 58.2; <0.01). Postoperative ejaculatory dysfunctions were observed in both groups, 58.8% in TURP and 34.5% in PVP group. The multivariate logistic regression analysis, adjusted for preoperative variables, showed that PVP was independently associated with BPH6 recovery end point (odds ratio=3.77; P<0.01). This study showed data in favor of PVP. Although IPSS and peak flow improvements were similar, PVP showed better clinical outcomes.

摘要

随着激光技术在该手术中成功作用的证据不断增加,良性前列腺梗阻的外科治疗方法也在随时间发生变化。我们旨在通过对BPH6的评估,比较前列腺绿激光汽化术(PVP)和双极经尿道前列腺切除术(TURP)在改善下尿路症状(LUTS)方面的效果。我们纳入了220例连续的LUTS患者。我们使用前列腺体积、峰值尿流率和国际前列腺症状评分(IPSS)进行倾向评分匹配。共分析了110例患者(55例行TURP,55例行PVP)。随访1年后,我们发现PVP组与TURP组相比,BPH6恢复更好的患者比例更高(45.6%对18.2%;P = 0.001)。TURP治疗的导尿时间更长(4.67对1.25;P < 0.01),而PVP的恢复体验更好(82.4对58.2;P < 0.01)。两组均观察到术后射精功能障碍,TURP组为58.8%,PVP组为34.5%。经术前变量调整的多因素逻辑回归分析显示,PVP与BPH6恢复终点独立相关(优势比 = 3.77;P < 0.01)。这项研究的数据支持PVP。尽管IPSS和峰值尿流率的改善相似,但PVP显示出更好的临床结果。

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本文引用的文献

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The impact of surgical treatments for lower urinary tract symptoms/benign prostatic hyperplasia on male erectile function: A systematic review and network meta-analysis.下尿路症状/良性前列腺增生手术治疗对男性勃起功能的影响:一项系统评价和网状Meta分析
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Prospective assessment of perioperative course in 2648 patients after surgical treatment of benign prostatic obstruction.对2648例良性前列腺梗阻手术治疗患者围手术期过程的前瞻性评估。
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