Gu Meng, Chen Yan-Bo, Liu Chong, Wan Xiang, Cai Zhi-Kang, Chen Qi, Wang Zhong
Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai, P.R. China .
J Endourol. 2018 Feb;32(2):139-143. doi: 10.1089/end.2017.0700.
To evaluate the long-term and flexible cystourethroscopy results of holmium laser enucleation of the prostate (HoLEP) and to compare them with those of plasmakinetic resection of the prostate (PKRP).
In the long-term follow-up, variables, including the international prostatic symptomatic score, quality of life scores, maximum flow rate (Qmax), and international index of erectile function (IIEF), and the adverse events, including the need for retreatment, were specifically assessed. One hundred twenty-two HoLEP and 119 PKRP of the initial 280 patients included in this study were available, with 10 deceased and 29 lost to follow-up.
We found that none of the assessable patients required reoperation for recurrent benign prostatic enlargement (BPE) in the HoLEP group, whereas two required reoperation in the PKRP group. There were no significant differences in most variables between the two groups in the long-term results. But in terms of Qmax, transrectal ultrasound prostate volume, prostate specific antigen (PSA) level, IIEF-5 score, and long-term posttrial follow-up of flexible cystourethroscopy, the HoLEP group showed better results.
The long-term follow-up data of this randomized trial confirm that HoLEP and PKRP are both effective and durable surgical interventions for the treatment of lower urinary tract symptoms due to BPE. Given the clinically relevant advantages associated with HoLEP, the alternation of PSA level, sexual function, and urination can be improved.
评估钬激光前列腺剜除术（HoLEP）的长期及灵活的膀胱尿道镜检查结果，并将其与前列腺等离子双极电切术（PKRP）的结果进行比较。
在长期随访中，具体评估了包括国际前列腺症状评分、生活质量评分、最大尿流率（Qmax）和国际勃起功能指数（IIEF）等变量，以及包括再次治疗需求在内的不良事件。本研究纳入的最初280例患者中，有122例行HoLEP，119例行PKRP，10例死亡，29例失访。
我们发现，在HoLEP组中，没有可评估的患者因复发性良性前列腺增生（BPE）需要再次手术，而PKRP组有2例需要再次手术。两组长期结果在大多数变量上无显著差异。但在Qmax、经直肠超声前列腺体积、前列腺特异性抗原（PSA）水平、IIEF-5评分以及灵活膀胱尿道镜检查的长期试验后随访方面，HoLEP组显示出更好的结果。
这项随机试验的长期随访数据证实，HoLEP和PKRP都是治疗BPE所致下尿路症状的有效且持久的手术干预措施。鉴于HoLEP具有临床相关优势，可改善PSA水平、性功能和排尿情况。
