Enikeev Dmitry, Taratkin Mark, Morozov Andrey, Singla Nirmish, Gabdulina Svetlana, Tarasov Alexander, Sukhanov Roman, Rivas Juan Gomez, Laukhtina Ekaterina, Arshiev Magomed, Mikhailov Vasiliy, Glybochko Petr
Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.
Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
J Endourol. 2020 Oct;34(10):1055-1063. doi: 10.1089/end.2020.0347. Epub 2020 Aug 4.
To analyze the long-term efficacy and safety of holmium laser enucleation of the prostate (HoLEP) for benign prostatic hyperplasia. A total of 127 patients who underwent HoLEP at our institution between 2013 and 2015 were included. Patients were observed for 5 years postoperatively. We evaluated the length of the surgery, the mass of the removed tissue, prostate-specific antigen level, the maximal flow rate (Qmax), postvoid residual (PVR), the length of catheterization and hospitalization, and the International Prostate Symptom Score (IPSS) and IPSS quality of life (QoL) at each clinic visit. PVR, Qmax, IPSS, and QoL all improved significantly immediately after the operation ( < 0.001). By the end of the 5th postoperative year, all the parameters showed a statistically meaningful decline: Qmax reduced by 5.8 mL/s (22.6%) and IPSS by 1.4 points (29.1%). Around 8.6% of the patients continued therapy with α-blockers. There were no differences in efficacy by the age of the patients or the volume of the prostate. Long-term complications and need for repeat operations were not affected by the volume of the prostate or patient age. The improvement of PVR, Qmax, IPSS, and QoL score seen in the early postoperative period after performing HoLEP remains evident at 5 years postoperatively. Long-term complications and the need for reoperation do not depend on the age of the patient or on the initial volume of the prostate.
分析钬激光前列腺剜除术（HoLEP）治疗良性前列腺增生的长期疗效和安全性。纳入2013年至2015年在本机构接受HoLEP手术的127例患者。术后对患者进行5年观察。我们评估了手术时间、切除组织重量、前列腺特异性抗原水平、最大尿流率（Qmax）、残余尿量（PVR）、导尿时间和住院时间，以及每次门诊时的国际前列腺症状评分（IPSS）和IPSS生活质量（QoL）。术后PVR、Qmax、IPSS和QoL立即均有显著改善（<0.001）。术后第5年末，所有参数均出现有统计学意义的下降：Qmax降低5.8 mL/s（22.6%），IPSS降低1.4分（29.1%）。约8.6%的患者继续使用α受体阻滞剂治疗。患者年龄或前列腺体积对疗效无差异。长期并发症和再次手术需求不受前列腺体积或患者年龄影响。钬激光前列腺剜除术后早期观察到的PVR、Qmax、IPSS和QoL评分改善在术后5年仍然明显。长期并发症和再次手术需求不取决于患者年龄或前列腺初始体积。
