Chung Amanda S J, Woo Henry H
Eastern Virginia Medical School, Norfolk, VA, USA.
Sydney Adventist Hospital Clinical School, University of Sydney, Sydney, NSW, Australia.
Asian J Urol. 2018 Jan;5(1):22-27. doi: 10.1016/j.ajur.2017.06.001. Epub 2017 Jun 9.
Transurethral resection of the prostate (TURP) became the gold standard surgical treatment for benign prostatic obstruction without undergoing randomized controlled trials against the predecessor standard in open suprapubic prostatectomy. TURP has historically been associated with significant morbidity and this has fuelled the development of minimally invasive surgical treatment options. Improvements in perioperative morbidity for TURP has been creating an ever increasing standard that must be met by any new technologies that are to be compared to this gold standard. Over recent years, there has been the emergence of novel minimally invasive treatments such as the prostatic urethral lift (PUL; UroLift System), convective WAter Vapor Energy (WAVE; Rezum System), Aquablation (AQUABEAM System), Histotripsy (Vortx Rx System) and temporary implantable nitinol device (TIND). Intraprostatic injections (NX-1207, PRX-302, botulinum toxin A, ethanol) have mostly been used with limited efficacy, but may be suitable for selected patients. This review evaluates these novel minimally invasive surgical options with special reference to the literature published in the past 5 years.
经尿道前列腺切除术（TURP）在未与之前的开放性耻骨上前列腺切除术这一标准术式进行随机对照试验的情况下，成为了治疗良性前列腺梗阻的金标准手术方式。从历史上看，TURP一直伴随着较高的发病率，这推动了微创外科治疗方案的发展。TURP围手术期发病率的改善不断提高标准，任何要与这一金标准相比较的新技术都必须达到这一不断提高的标准。近年来，出现了一些新型的微创治疗方法，如前列腺尿道悬吊术（PUL；UroLift系统）、对流式水汽能量疗法（WAVE；Rezum系统）、水消融术（AQUABEAM系统）、组织粉碎术（Vortx Rx系统）和临时可植入镍钛诺装置（TIND）。前列腺内注射（NX - 1207、PRX - 302、A型肉毒杆菌毒素、乙醇）大多疗效有限，但可能适用于特定患者。本综述特别参考过去5年发表的文献，对这些新型微创外科手术方案进行评估。
