Department of Urology, ASL Abruzzo2, Via S. Camillo de Lellis 1, 66054, Vasto, Chieti, Italy.
Department of Urology, "Sant'Andrea" Hospital, Sapienza University, Rome, Italy.
World J Urol. 2018 Jan;36(1):91-97. doi: 10.1007/s00345-017-2106-5. Epub 2017 Nov 1.
To compare the efficacy, safety, Patient Global Impression of Improvement (PGI-I), and complications rates after 180-W GreenLight laser (180-W GL laser) standard and anatomical photoselective vaporization (sPVP and aPVP).
Within a multi-institutional database, we identified patients who underwent sPVP or aPVP to relief BPH symptoms. IPSS, Q , and prostate-specific antigen (PSA) were measured at baseline and during the follow-up. PGI-I score as well as early and late complications were recorded at follow-up visits. Log-binomial and multivariable proportional odds regression models were fitted to estimate the effect of aPVP vs. sPVP on PGI-I as well as on early and late complication rates, before and after adjustment for propensity score.
813 patients were included. Of those, the 50.4% underwent aPVP. Patients who underwent aPVP had larger prostate (64 vs. 55 mL, p < 0.001) and higher baseline PSA levels (3.1 vs. 2.5 ng/mL, p < 0.001). PGI-I score was signaled as very improved, improved, slightly improved, unchanged, or worsened in 55.5, 32.8, 8.3, 2.3, and 1.2% of the cases, respectively, with no differences according the technique used (p = 0.420). Acute urinary retention occurred in 9.2 vs. 8.9% of patients after aPVP vs. sPVP (p = 0.872). All models failed to find differences in: patients' satisfaction (OR 1.19, p = 0.256), early complications (RR 0.93, p = 0.387), early urge/incontinence symptoms (RR 0.97, p = 0.814), and late complications rates (RR 0.70, p = 0.053), after aPVP vs. sPVP.
Our results showed similar functional results and complication rates after aPVP and sPVP. However, aPVP was used in larger prostates. Both techniques guarantee high patient's satisfaction.
比较 180-W 绿激光（180-W GL 激光）标准治疗和解剖性光选择性前列腺汽化术（sPVP 和 aPVP）的疗效、安全性、患者整体印象改善（PGI-I）和并发症发生率。
在多机构数据库中，我们确定了接受 sPVP 或 aPVP 缓解 BPH 症状的患者。在基线和随访期间测量国际前列腺症状评分（IPSS）、Q 和前列腺特异性抗原（PSA）。在随访时记录 PGI-I 评分以及早期和晚期并发症。在调整倾向评分之前和之后，使用对数二项式和多变量比例优势回归模型来估计 aPVP 与 sPVP 对 PGI-I 以及早期和晚期并发症发生率的影响。
共纳入 813 例患者，其中 50.4%接受 aPVP。接受 aPVP 的患者前列腺较大（64 与 55 mL，p<0.001），基线 PSA 水平较高（3.1 与 2.5 ng/mL，p<0.001）。PGI-I 评分分别在 55.5%、32.8%、8.3%、2.3%和 1.2%的病例中被标记为非常改善、改善、略有改善、无变化或恶化，与使用的技术无关（p=0.420）。aPVP 后急性尿潴留发生率为 9.2%，sPVP 后为 8.9%（p=0.872）。所有模型均未发现 aPVP 与 sPVP 相比，患者满意度（OR 1.19，p=0.256）、早期并发症（RR 0.93，p=0.387）、早期急迫/失禁症状（RR 0.97，p=0.814）和晚期并发症发生率（RR 0.70，p=0.053）存在差异。
我们的结果显示 aPVP 和 sPVP 后功能结果和并发症发生率相似。然而，aPVP 用于更大的前列腺。两种技术都能保证患者的高度满意度。
