Magistro G, Stief C G, Gratzke C
Urologische Klinik und Poliklinik der Universität München, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, München, Deutschland.
Klinik für Urologie, Universitätsklinikum Freiburg, Freiburg, Deutschland.
Urologe A. 2019 Mar;58(3):254-262. doi: 10.1007/s00120-019-0876-7.
Novel minimally invasive treatment options strive for innovative approaches that are equally efficient to standard procedures with a superior safety profile. A true minimally invasive technique can be performed in an ambulatory setting under local anaesthesia and no need for postinterventional catheterization so that quick and problem-free return to everyday life is possible. Sexual dysfunction is a great concern of sexually active patients facing surgery. The novel techniques clearly demonstrate that relief of bothersome lower urinary tract symptoms (LUTS) is possible without compromising erectile and ejaculatory function. Urolift® is an attractive treatment option for carefully selected patients without a middle lobe who have special interest in the rapid and smooth return to daily activity and the complete preservation of sexual function. Rezũm® and AquaBeam® are promising novel techniques that can be also performed in the presence of certain prostatic features like a middle lobe. iTIND® is still in its infancy of clinical evaluation and therefore, its true value still needs to be determined. According to current data the role of intraprostatic injectables for the treatment of male LUTS is still unclear.
新型微创治疗方案致力于采用创新方法,这些方法在安全性方面优于标准程序,同时效率相当。真正的微创技术可在门诊局部麻醉下进行,无需介入后导管插入术,从而能够快速且顺利地恢复日常生活。性功能障碍是接受手术的性活跃患者极为关注的问题。新技术清楚地表明,在不损害勃起和射精功能的情况下,缓解令人烦恼的下尿路症状(LUTS)是可能的。对于精心挑选的没有中叶且特别希望快速顺利恢复日常活动并完全保留性功能的患者,Urolift®是一种有吸引力的治疗选择。Rezũm®和AquaBeam®是有前景的新技术,在存在某些前列腺特征(如中叶)的情况下也可进行。iTIND®仍处于临床评估的初期阶段,因此其真正价值仍有待确定。根据目前的数据,前列腺内注射剂在治疗男性LUTS中的作用仍不明确。