Department of Urology, Ludwig Maximilian University of Munich, Munich, Germany.
Curr Opin Urol. 2018 May;28(3):294-300. doi: 10.1097/MOU.0000000000000502.
The main objective of novel minimally invasive treatment options is to provide relief of bothersome lower urinary tract symptoms (LUTS) equally effective to current standard techniques, but with a more favorable safety profile. Here we present the first clinical experience with the prostatic urethral lift (Urolift) and the convective water vapor energy ablation (Rezūm).
Urolift offers rapid and durable relief of LUTS with complete preservation of sexual function. It is not as effective as the reference method transurethral resection of the prostate (TURP) in terms of symptom relief and urodynamic parameters, but it in selected patients with special interest in sexual activity and rapid recovery it may be an attractive option. The Rezūm system also offers rapid and safe relief of LUTS without compromising sexual function. But it targets all critical prostatic zones including an obstructive middle lobe.
In selected patients with bothersome LUTS, who seek a minimally invasive procedure offering a fast return to daily activity and complete preservation of sexual function, Urolift is a good option. First 3-year clinical data on Rezūm demonstrated efficacy and safety in a prospective randomized, sham-controlled trial. It addresses all critical zones of benign prostatic obstruction including the middle lobe without compromising sexual function. Long-term data and the direct comparison with the reference method TURP are missing to define its role in the surgical spectrum of minimally invasive treatment options.
新型微创治疗选择的主要目的是提供与当前标准技术同样有效的、令人烦恼的下尿路症状（LUTS）缓解，但具有更有利的安全性特征。本文介绍了前列腺尿道提升术（Urolift）和对流水蒸汽能量消融术（Rezūm）的初步临床经验。
Urolift 可快速且持久地缓解 LUTS，同时完全保留性功能。就症状缓解和尿动力学参数而言，它不如参考方法经尿道前列腺切除术（TURP）有效，但对于对性行为和快速恢复特别感兴趣的特定患者，它可能是一种有吸引力的选择。Rezūm 系统还可快速且安全地缓解 LUTS，而不影响性功能。但它针对所有关键的前列腺区域，包括阻塞性中叶。
对于有令人烦恼的 LUTS 的特定患者，他们寻求微创程序，提供快速恢复日常活动和完全保留性功能，Urolift 是一个不错的选择。Rezūm 的 3 年临床初步数据显示了在一项前瞻性随机、假对照试验中的疗效和安全性。它解决了包括中叶在内的所有良性前列腺阻塞的关键区域，而不影响性功能。目前尚缺乏长期数据和与参考方法 TURP 的直接比较，无法确定其在微创治疗选择的手术范围内的作用。
