Seizilles de Mazancourt Emilien, Pagnoux Gaelle, Codas Duarte Ricardo, Moldovan Paul Cezar, Ruffion Alain, Colombel Marc, Badet Lionel, Fassi-Fehri Hakim
Department of Urology and Transplant Surgery, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.
Department of Urinary and Vascular Imaging, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France.
World J Urol. 2023 Jan;41(1):151-157. doi: 10.1007/s00345-022-04225-7. Epub 2022 Dec 1.
Holmium Laser Enucleation of the Prostate (HoLEP) and Prostatic Artery Embolization (PAE) are novel techniques for the treatment of benign prostatic hyperplasia lower urinary tract symptoms (BPH-LUTS). The objective of this study was to describe and compare the functional results and complications of these two techniques at one year follow-up.
We performed a retrospective, monocentric study of all patients consecutively treated in our center with HoLEP or PAE for symptomatic or complicated BPH between January 2016 and December 2019. Data regarding patient and perioperative characteristics, follow-up biological results, functional questionnaires and uroflowmetry were collected from medical records.
A total of 490 and 57 patients were treated with HoLEP and PAE, respectively. The demographic and clinical characteristics of the two groups were similar. The operative time was significantly higher for PAE (p < 0.001) and hospitalization time longer after HoLEP (p = 0.0006). The urinary catheterization time was longer after PAE (p < 0.001). The prostatic volume treated was higher with HoLEP than with PAE (56% versus 26%, p < 0.001). The mean difference in IPSS from baseline to 12 months was significantly higher after HoLEP than after PAE: - 17.58 versus - 8 (p < 0.001). The mean difference in QoL-IPSS from baseline to 12 months was significantly higher after HoLEP: - 4.09 versus - 2.27 (p < 0.001). The rate of postoperative adverse events in the first three months was similar between the two groups:35% after HoLEP and 33% after PAE (p = 0.88).
HoLEP and PAE both significantly improved BPH-LUTS, with HoLEP having an advantage over PAE.
钬激光前列腺剜除术（HoLEP）和前列腺动脉栓塞术（PAE）是治疗良性前列腺增生所致下尿路症状（BPH-LUTS）的新技术。本研究的目的是描述并比较这两种技术在一年随访时的功能结果及并发症。
我们对2016年1月至2019年12月期间在本中心连续接受HoLEP或PAE治疗有症状或复杂BPH的所有患者进行了一项回顾性单中心研究。从病历中收集了有关患者及围手术期特征、随访生物学结果、功能问卷及尿流率测定的数据。
分别有490例和57例患者接受了HoLEP和PAE治疗。两组的人口统计学和临床特征相似。PAE的手术时间显著更长（p＜0.001），HoLEP后的住院时间更长（p = 0.0006）。PAE后的导尿时间更长（p＜0.001）。HoLEP治疗的前列腺体积大于PAE（56%对26%，p＜0.001）。从基线到12个月，HoLEP后的国际前列腺症状评分（IPSS）平均差值显著高于PAE：-17.58对-8（p＜0.001）。从基线到12个月，HoLEP后的生活质量-IPSS平均差值显著更高：-4.09对-2.27（p＜0.001）。两组在前三个月的术后不良事件发生率相似：HoLEP后为35%，PAE后为33%（p = 0.88）。
HoLEP和PAE均能显著改善BPH-LUTS，且HoLEP优于PAE。
