Carmignani Luca, Clementi Maria Chiara, Signorini Claudia, Motta Gloria, Nazzani Sebastiano, Palmisano Franco, De Lorenzis Elisa, Catellani Michele, Mistretta Alessandro Francesco, Conti Andrea, Tringali Valeria, Costa Maria Beatrice, Vizziello Damiano
Policlinico San Donato, Urology, San Donato, Milanese, Italy.
Ospedale Maggiore Policlinico, Urology, Milan, Italy.
Asian J Urol. 2019 Jul;6(3):270-274. doi: 10.1016/j.ajur.2018.05.004. Epub 2018 May 17.
We aimed to determine safety and feasibility of thulium laser transurethral vapoenucleation of prostate (ThuVEP) for treatment of obese patients affected by benign prostatic hyperplasia (BPH).
We retrospectively analysed data of 452 patients with BPH who underwent ThuVEP from February 2012 to March 2016 in a single center. Patients were divided into three groups according to body mass index (BMI, kg/m): Normal weight (18.5 ≤ BMI < 25; Group A), overweight (25 ≤ BMI < 30; Group B) and obese (BMI ≥ 30; Group C), for a total of 412 patients evaluable for this study. Preoperative total serum prostate-specific antigen (PSA), digital rectal examination of the prostate, transrectal ultrasound (TRUS), renal ultrasound, urine culture, uroflowmetry, International Prostate Symptoms Score (IPSS), and Quality of Life (QoL) score were analyzed. Post-operative complications, hospital stay and days of catheterization, questionnaires and uroflowmetry at 1 and 3 months after surgery were evaluated. Preoperative data, surgical outcomes, complication rate and clinical outcomes were compared between groups.
The median age of patients was 69 years (Interquartile Range [IQR 10]). The preoperative median IPSS among groups was 19 (IQR 8.75), 20 (IQR 10), and 18 (IQR 10) respectively. At 1 and 3 months of follow-up, this value was 8 (IQR 7), 8 (IQR 4), 7 (IQR 5) and 5 (IQR 6.25), 5 (IQR 6), 6 (IQR 5), respectively (all between groups > 0.05). There was no statistically significant difference among three groups as for hospital stay and days of catheterization ( > 0.05).
Our results showed that ThuVEP was safe and feasible even in overweight patients with substantially enlarged prostate.
我们旨在确定铥激光经尿道前列腺汽化剜除术（ThuVEP）治疗肥胖的良性前列腺增生（BPH）患者的安全性和可行性。
我们回顾性分析了2012年2月至2016年3月在单一中心接受ThuVEP的452例BPH患者的数据。根据体重指数（BMI，kg/m）将患者分为三组：正常体重（18.5≤BMI＜25；A组）、超重（25≤BMI＜30；B组）和肥胖（BMI≥30；C组），共有412例患者可纳入本研究进行评估。分析术前总血清前列腺特异性抗原（PSA）、前列腺直肠指检、经直肠超声（TRUS）、肾脏超声、尿培养、尿流率、国际前列腺症状评分（IPSS）和生活质量（QoL）评分。评估术后并发症、住院时间和导尿天数、术后1个月和3个月的问卷调查和尿流率。比较各组术前数据、手术结果、并发症发生率和临床结果。
患者的中位年龄为69岁（四分位间距[IQR 10]）。各组术前IPSS中位数分别为19（IQR 8.75）、20（IQR 10）和18（IQR 10）。在随访1个月和3个月时，该值分别为8（IQR 7）、8（IQR 4）、7（IQR 5）和5（IQR 6.25）、5（IQR 6）、6（IQR 5）（组间均>0.05）。三组在住院时间和导尿天数方面无统计学显著差异（>0.05）。
我们的结果表明，即使是前列腺明显增大的超重患者，ThuVEP也是安全可行的。
