Aho Tevita, Armitage James, Kastner Christof
Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Andrologia. 2020 Sep;52(8):e13643. doi: 10.1111/and.13643. Epub 2020 May 13.
Anatomical endoscopic enucleation of the prostate (AEEP) differs from other surgical techniques for benign prostatic obstruction (BPO) in that it removes the entire benign prostatic hyperplasia (BPH) component of the prostate. We summarise the main advantages of AEEP compared to other surgical techniques for BPO. These include better urodynamic relief of bladder outlet obstruction, superior outcomes for urinary retention even in the presence of impaired detrusor contractility, safe and effective for any size prostate, and superior durability compared to vaporisation and resection techniques. We summarise evidence that suggests AEEP offers outcomes that are independent of patient age and prostate volume. We conclude that AEEP is the gold standard surgical treatment for men with either lower urinary tract symptoms (LUTS) or urinary retention, regardless of prostate volume, detrusor contractility and age. It offers the ability to safely and effectively treat a wider range of patients than any other BPO procedure. More widespread use of mentorship programmes, that take advantage of the growing number of experienced mentors, is recommended to train more urologists in AEEP.
前列腺解剖性内镜剜除术（AEEP）与其他治疗良性前列腺梗阻（BPO）的手术技术不同，在于它能切除前列腺的整个良性前列腺增生（BPH）部分。我们总结了AEEP相较于其他治疗BPO手术技术的主要优势。这些优势包括更好地通过尿动力学缓解膀胱出口梗阻、即使在逼尿肌收缩功能受损的情况下对尿潴留也有更好的治疗效果、对任何大小的前列腺都安全有效，以及与汽化和切除技术相比具有更好的持久性。我们总结了相关证据，表明AEEP的治疗效果与患者年龄和前列腺体积无关。我们得出结论，AEEP是治疗有下尿路症状（LUTS）或尿潴留男性患者的金标准手术治疗方法，无论其前列腺体积、逼尿肌收缩功能和年龄如何。与任何其他BPO手术相比，它能够安全有效地治疗更广泛范围的患者。建议更广泛地利用越来越多经验丰富的指导者开展指导计划来培训更多的泌尿外科医生掌握AEEP技术。
