Lamersdorf Tobias, Netsch Christopher, Becker Benedikt, Wülfing Christian, Anheuser Petra, Engel Oliver, Gross Andreas J, Rosenbaum Clemens Mathias
Department of Urology, Asklepios Hospital Barmbek, 22307 Hamburg, Germany.
Department of Urology, Asklepios Hospital Altona, 22763 Hamburg, Germany.
J Clin Med. 2023 Feb 1;12(3):1174. doi: 10.3390/jcm12031174.
Prostate cancer (PCa) and benign prostatic hyperplasia (BPH) are common in elderly men. Data on the laser-based surgery known as thulium vapoenucleation of the prostate (ThuVEP) in PCa patients are rare. Our objective was to analyse the feasibility, safety and functional outcome of ThuVEP in patients with lower urinary tract symptoms (LUTS) and PCa. Multicentre study, including 1256 men who underwent ThuVEP for LUTS. Maximum urinary flow rate (Qmax) and post-void residual volume (PVR) were measured perioperatively. The International Prostate Symptome Score (IPSS) was measured perioperatively and at follow-up (FU). Perioperative complications were captured. Reoperation rate was captured at FU. Of 994 men with complete data, 286 (28.8%) patients had PCa. The most common Gleason score was 3 + 3 in 142 patients (49.7%). Most common was low-risk PCa (141 pts; 49.3%). PCa patients were older, had smaller prostates and had higher prostate-specific antigen (PSA) values (all < 0.001). Comparing non-PCa and PCa patients, no differences occurred perioperatively. IPSS, quality of life and PVR decreased (all < 0.001) and Qmax improved ( < 0.001) in both groups. Reoperation rates did not differ. The results of low- vs. intermediate-/high-risk PCa patients were comparable. ThuVEP is a safe and long-lasting treatment option for patients with LUTS with or without PCa. No differences occurred when comparing low- to intermediate-/high-risk PCa patients.
前列腺癌（PCa）和良性前列腺增生（BPH）在老年男性中很常见。关于前列腺癌患者中一种名为前列腺铥蒸汽汽化术（ThuVEP）的激光手术的数据很少。我们的目的是分析ThuVEP在有下尿路症状（LUTS）的前列腺癌患者中的可行性、安全性和功能结果。多中心研究，包括1256名因LUTS接受ThuVEP的男性。围手术期测量最大尿流率（Qmax）和排尿后残余尿量（PVR）。围手术期和随访（FU）时测量国际前列腺症状评分（IPSS）。记录围手术期并发症。随访时记录再次手术率。在994名有完整数据的男性中，286名（28.8%）患者患有前列腺癌。最常见的Gleason评分为3+3，共142例患者（49.7%）。最常见的是低风险前列腺癌（141例；49.3%）。前列腺癌患者年龄更大，前列腺更小，前列腺特异性抗原（PSA）值更高（所有P<0.001）。比较非前列腺癌和前列腺癌患者，围手术期无差异。两组患者的IPSS、生活质量和PVR均下降（所有P<0.001），Qmax均改善（P<0.001）。再次手术率无差异。低风险与中/高风险前列腺癌患者的结果相当。ThuVEP对于有或没有前列腺癌的LUTS患者是一种安全且持久的治疗选择。比较低风险与中/高风险前列腺癌患者时无差异。
