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老年男性绿激光联合经尿道前列腺切除术的管理

Management of greenlight laser plus transurethral resection of prostate for elderly men.

作者信息

Zhang Zhi-Hua, Luo Fei, Su Yan-Hui, Li Jian

机构信息

Department of Urology, Tianjin Union Medical Center, Hong-qiao District, Tianjin, China.

出版信息

Medicine (Baltimore). 2018 Aug;97(33):e11862. doi: 10.1097/MD.0000000000011862.

Abstract

The study is aiming to evaluate the treatment safety and efficacy of greenlight laser photovaporization of the prostate (PVP) combined with transurethral electrovaporization resection (TUVP) for elderly (≥ 70 years) men with lower urinary tract symptoms due to benign prostatic hyperplasia (BPH/LUTS) with a large prostate volume (≥ 80 mL). One hundred twelve BPH/LUTS patients treated with PVP were divided into 2 groups according to prostate volume (PV), the outcomes of the 2 groups were assessed at 12 months after the operation. Patients in the PV ≥ 80 group (n = 51) had a higher level of maximum detrusor pressure (Pdet.max) than those in the PV < 80 group (n = 61) (97.14  ±  36.68 vs 70.70 ± 32.55, P < .001). Pdet.max level of the 2 groups was significantly decreased at the end of follow-up. International Prostate Symptom Score questionnaires (IPSS) score, maximum flow rate (Qmax), and residual urine volume (PVR) were significantly improved in comparison to the preoperative status (P < .001). PVP combined with TUVP can significantly improve outcomes (IPSS, Qmax, PVR) and is a safe and effective technique for elderly BPH/LUTS patients with a large prostate volume.

摘要

本研究旨在评估绿激光前列腺汽化术(PVP)联合经尿道电汽化切除术(TUVP)治疗前列腺体积较大(≥80 mL)的老年(≥70岁)良性前列腺增生所致下尿路症状(BPH/LUTS)患者的治疗安全性和疗效。112例接受PVP治疗的BPH/LUTS患者根据前列腺体积(PV)分为2组,术后12个月评估两组的治疗结果。PV≥80组(n = 51)患者的最大逼尿肌压力(Pdet.max)水平高于PV<80组(n = 61)患者(97.14±36.68 vs 70.70±32.55,P<0.001)。随访结束时,两组的Pdet.max水平均显著降低。与术前状态相比,国际前列腺症状评分问卷(IPSS)评分、最大尿流率(Qmax)和残余尿量(PVR)均显著改善(P<0.001)。PVP联合TUVP可显著改善治疗结果(IPSS、Qmax、PVR),是治疗前列腺体积较大的老年BPH/LUTS患者的一种安全有效的技术。

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