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超声引导经会阴激光消融术治疗良性前列腺增生:一种新的微创介入治疗方法。

Ultrasound-guided transperineal laser ablation for percutaneous treatment of benign prostatic hyperplasia: a new minimally invasive interventional therapy.

机构信息

Department of Ultrasound, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, PR China.

Department of Ultrasound, Zhejiang Hospital, Hangzhou, Zhejiang Province, PR China.

出版信息

Acta Radiol. 2022 Apr;63(4):553-558. doi: 10.1177/02841851211003289. Epub 2021 Mar 28.

Abstract

BACKGROUND

Although there are different treatments for benign prostate hyperplasia, their efficacy and safety differ. We are currently exploring a new minimally invasive interventional therapy for benign prostatic hyperplasia (BPH).

PURPOSE

To determine the feasibility, effectiveness, and safety of ultrasound-guided transperineal laser ablation (US-TPLA) for the treatment of BPH.

MATERIAL AND METHODS

Twenty patients with BPH (mean age = 73.9 ± 9.2 years) who underwent US-TPLA from June 2018 to January 2020 with a subsequent six-month follow-up were retrospectively reviewed. After local anesthesia, a 21-G trocar was inserted into the prostate tissue under ultrasound monitoring, followed by 1064 nm diode laser irradiation. Changes in international prostate symptom score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), postvoid residual (PVR), prostate volume, and complications were evaluated six months after surgery.

RESULTS

All patients underwent the operation successfully without serious complications. After six months, the average IPSS improved from 22.7 ± 5.3 to 9.1 ± 3.2 ( < 0.001), the QoL improved from 4.9 ± 1.7 to 2.3 ± 1.3 ( < 0.001), the Qmax improved from 8.5 ± 3.0 to 15.2 ± 4.8 mL/s ( < 0.001), the PVR increased from 78.7 ± 58.8 to 30.3 ± 34.2 ( < 0.05), and the mean prostate volume ranged from 70.8 ± 23.8 to 54.7 ± 20.9 mL ( < 0.05).

CONCLUSION

US-TPLA is safe and feasible for the treatment of BPH. An evaluation at the six-month follow-up is effective.

摘要

背景

尽管治疗良性前列腺增生的方法有很多,但它们的疗效和安全性却各不相同。目前,我们正在探索一种治疗良性前列腺增生(BPH)的新型微创介入治疗方法。

目的

评估经会阴超声引导激光消融术(US-TPLA)治疗 BPH 的可行性、有效性和安全性。

材料和方法

回顾性分析 2018 年 6 月至 2020 年 1 月期间 20 例接受 US-TPLA 治疗的 BPH 患者(平均年龄 73.9 ± 9.2 岁),并随访 6 个月。在局部麻醉下,在超声监测下将 21G 套管针插入前列腺组织,然后进行 1064nm 二极管激光照射。术后 6 个月评估国际前列腺症状评分(IPSS)、生活质量(QoL)、最大尿流率(Qmax)、剩余尿量(PVR)、前列腺体积和并发症的变化。

结果

所有患者均成功完成手术,无严重并发症。术后 6 个月,IPSS 评分由 22.7 ± 5.3 降至 9.1 ± 3.2( < 0.001),QoL 评分由 4.9 ± 1.7 降至 2.3 ± 1.3( < 0.001),Qmax 由 8.5 ± 3.0 升至 15.2 ± 4.8 mL/s( < 0.001),PVR 由 78.7 ± 58.8 升至 30.3 ± 34.2( < 0.05),前列腺体积由 70.8 ± 23.8 降至 54.7 ± 20.9 mL( < 0.05)。

结论

US-TPLA 治疗 BPH 安全、可行,6 个月随访评估有效。

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