Park Sejun, Kwon Taekmin, Park Sungchan, Moon Kyung Hyun
Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. urofirst@hanm ail.net.
World J Mens Health. 2017 Dec;35(3):163-169. doi: 10.5534/wjmh.17011. Epub 2017 Nov 20.
We investigated the effects of holmium laser enucleation of the prostate (HoLEP) in patients with a small prostate (≤30 mL) in whom medical treatment was ineffective.
Data from 132 patients who underwent HoLEP by a single surgeon between 2012 and 2015 were retrospectively analyzed. All patients received benign prostatic hyperplasia medication for at least 6 months before surgery. The patients were divided into 2 groups according to prostate size: group 1, ≤30 mL (n=30); and group 2, >30 mL (n=102). Clinical characteristics and the International Prostate Symptom Score (IPSS), including quality of life (QoL), peak urinary flow rate (Qmax), and postvoid residual urine (PVR), before surgery and 3 months postoperatively, were compared between the 2 groups.
In group 1, the IPSS, QoL, and PVR significantly decreased and the Qmax significantly increased 3 months after surgery. The voiding subscore also significantly decreased 3 months after surgery (p<0.001), but the storage subscore was not significantly different (p=0.055). In group 2, hemoglobin, the IPSS, QoL, and PVR significantly decreased and the Qmax significantly increased 3 months after surgery. In these patients, both the storage subscore and voiding subscore significantly decreased after surgery (both p<0.001). There were no significant differences between the groups in hemoglobin, IPSS, QoL, Qmax, and PVR either before or 3 months after surgery.
When other medical treatments are ineffective, HoLEP is an effective intervention for patients with a small prostate.
我们研究了钬激光前列腺剜除术（HoLEP）对前列腺体积较小（≤30 mL）且药物治疗无效的患者的疗效。
回顾性分析了2012年至2015年间由同一位外科医生为132例患者实施HoLEP的数据。所有患者在手术前均接受了至少6个月的良性前列腺增生药物治疗。根据前列腺大小将患者分为两组：第1组，≤30 mL（n = 30）；第2组，>30 mL（n = 102）。比较两组患者手术前及术后3个月的临床特征和国际前列腺症状评分（IPSS），包括生活质量（QoL）、最大尿流率（Qmax）和残余尿量（PVR）。
在第1组中，术后3个月IPSS、QoL和PVR显著降低，Qmax显著增加。排尿子评分在术后3个月也显著降低（p<0.001），但储尿子评分无显著差异（p = 0.055）。在第2组中，术后3个月血红蛋白、IPSS、QoL和PVR显著降低，Qmax显著增加。在这些患者中，术后储尿子评分和排尿子评分均显著降低（均p<0.001）。两组患者在手术前及术后3个月的血红蛋白、IPSS、QoL、Qmax和PVR方面均无显著差异。
当其他药物治疗无效时，HoLEP是前列腺体积较小患者的有效干预措施。
