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雷祖姆治疗术:雷祖姆治疗术治疗前列腺良性增生症手术后复发下尿路症状患者的早期疗效。

Rezum to the rescue: Early outcomes of Rezum on patients with recurrent lower urinary tract symptoms after surgical interventions for benign prostatic enlargement.

机构信息

Department of Urology, Ng Teng Fong General Hospital, NUHS, Singapore, Singapore.

Department of Urology, Singapore General Hospital, Singapore, Singapore.

出版信息

Andrologia. 2022 Sep;54(8):e14450. doi: 10.1111/and.14450. Epub 2022 Apr 26.

Abstract

We aim to report the short-term outcomes of patients undergoing Rezum as a re-treatment intervention for recurrent lower urinary tract symptoms after prior surgical treatment for benign prostate enlargement. Data from two institutions for baseline International Prostatic Symptom Score with Quality of life item, prostate size, and maximum flow-rate was acquired. Patients were assessed 3-month post-treatment. Outcomes were compared with unpaired t-tests and Fisher's exact tests. Nineteen patients were included. Prior surgical interventions included transurethral resection of the prostate (31.6%, n = 6), Urolift (26.3%, n = 5), transurethral bladder neck incision (15.8%, n = 3), prostate artery embolization (10.5%, n = 2), transurethral needle ablation, greenlight photovaporization of prostate and Rezum (5.3%, n = 1 each). Median age was 69.0 years (IQR 14; range 59-87 years) with a median prostate volume of 65.0 ml (IQR 63; range 22-160 ml). The median time to Rezum treatment was 48 months (IQR 78; range 9-240 months). 63.1% (n = 12) were re-started on benign prostatic enlargement medication and 36.8% (n = 7) had recurrent bothersome symptoms before re-treatment with Rezum. At 3-month follow up, median International Prostatic Symptom Score decreased from 23 to 9 (p < 0.001) and Quality of life from 4 to 2 (p < 0.001). Median maximum flow-rate improved after treatment from 8.6 to 14.8 ml/s (p < 0.001). None of the patients were required to restart medication for benign prostate enlargement.

摘要

我们旨在报告 Rezum 治疗复发性下尿路症状的短期疗效,这些患者既往因良性前列腺增生接受过手术治疗。本研究获取了来自两个中心的患者基线时国际前列腺症状评分(包括生活质量指数)、前列腺体积和最大尿流率的数据,在治疗后 3 个月对患者进行评估。使用独立样本 t 检验和 Fisher 确切概率法对结果进行比较。共纳入 19 例患者,既往接受过的手术治疗包括经尿道前列腺切除术(31.6%,n=6)、Urolift(26.3%,n=5)、经尿道膀胱颈切开术(15.8%,n=3)、前列腺动脉栓塞术(10.5%,n=2)、经尿道针状电极消融术、绿激光前列腺汽化术和 Rezum(各 5.3%,n=1)。中位年龄为 69.0 岁(IQR 14;范围 59-87 岁),前列腺体积中位值为 65.0ml(IQR 63;范围 22-160ml)。Rezum 治疗的中位时间为 48 个月(IQR 78;范围 9-240 个月)。63.1%(n=12)重新开始使用治疗良性前列腺增生的药物,36.8%(n=7)在接受 Rezum 治疗前出现复发性症状。在 3 个月随访时,国际前列腺症状评分从 23 分降至 9 分(p<0.001),生活质量评分从 4 分降至 2 分(p<0.001)。治疗后最大尿流率从 8.6ml/s 提高至 14.8ml/s(p<0.001)。无一例患者需要重新开始使用治疗良性前列腺增生的药物。

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