McVary Kevin T, Rogers Tyson, Roehrborn Claus G
Department of Urology, Loyola University Medical Center, Maywood, IL.
NAMSA, Minneapolis, MN.
Urology. 2019 Apr;126:171-179. doi: 10.1016/j.urology.2018.12.041. Epub 2019 Jan 21.
To report 4-year outcomes of the randomized controlled trial of water vapor thermal therapy for treatment of moderate to severe lower urinary tract symptoms due to benign prostatic hyperplasia.
Total 188 subjects; 135 men ≥50years old, International Prostate Symptom Score ≥ 13, maximum flow rate (Qmax) ≤15 mL/s and prostate volume 30 to 80 cc treated with Rezūm System thermal therapy were followed 4 years; subset of 53 men who requalified for crossover from control to active treatment were followed 3years.
Lower urinary tract symptoms were significantly improved within ≤3 months after thermal therapy and remained consistently durable (International Prostate Symptom Score 47%, quality of life 43%, Qmax 50%, Benign Prostatic Hyperplasia Impact Index 52%) throughout 4years (P <.0001); outcomes were similarly sustained in crossover subjects at 3years. Surgical retreatment rate was 4.4% over 4years. No disturbances in sexual function were reported.
The minimally invasive thermal therapy provides effective symptom relief and improved quality of life that remains durable for over 4years. It is applicable to all prostate zones with procedures performed under local anesthesia in an office setting.
报告水蒸气热疗法治疗良性前列腺增生所致中重度下尿路症状的随机对照试验的4年结果。
共188名受试者;135名年龄≥50岁、国际前列腺症状评分≥13、最大尿流率(Qmax)≤15 mL/s且前列腺体积为30至80 cc的男性接受了Rezūm系统热疗法,并随访4年;53名符合从对照转为积极治疗条件的男性亚组随访3年。
热疗后≤3个月内下尿路症状显著改善,且在4年期间持续保持良好效果(国际前列腺症状评分改善47%,生活质量改善43%,Qmax改善50%,良性前列腺增生影响指数改善52%)(P<.0001);交叉试验受试者在3年时也有类似的持续效果。4年期间手术再治疗率为4.4%。未报告性功能障碍。
微创热疗法能有效缓解症状并改善生活质量,且这种效果可持续4年以上。它适用于所有前列腺区域,可在门诊局部麻醉下进行操作。