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钬激光 Xpeeda 汽化术与绿激光前列腺汽化术治疗良性前列腺梗阻的随机对照临床研究:1 年结果。

Holmium Laser Xpeeda Vaporization GreenLight XPS Vaporization of the Prostate for Benign Prostatic Obstruction: 1-Year Results from a Randomized Controlled Clinical Study.

机构信息

Urology Department, Northern Ontario School of Medicine, Thunder Bay, Canada.

Urology Department, Menoufia University, Shebin Elkom, Egypt.

出版信息

J Endourol. 2023 Jun;37(6):706-712. doi: 10.1089/end.2022.0727. Epub 2023 May 22.

Abstract

To compare the safety and efficacy of Holmium Laser Xpeeda Vaporization and GreenLight XPS Vaporization of the prostate in patients with prostate size ≤80 g. Ninety-two men with benign prostatic hyperplasia (BPH) and prostate size ≤80 g scheduled for laser prostatectomy were included in this prospective randomized trial. Outcome measures were collected and compared, including International Prostate Symptom Score (IPSS), quality of life (QoL), flow rate, postvoid residual urine volume (PVR), International Index of Erectile Dysfunction (IIEF)-15, prostate-specific antigen (PSA), transrectal ultrasound prostate volume, and catheterization time. Perioperative complications were also recorded. Patients were offered a trial of void (TOV) 3 hours after their procedures. All patients were followed-up at 1, 3, 6, and 12 months. There were no significant differences in preoperative baseline data between the two surgical groups. Operative parameters and postoperative outcomes were comparable. Effective same-day TOV was noted in 73.1% and 72.7% of the Xpeeda and GreenLight XPS patients, respectively ( = 0.98). All patients were discharged home within 24 hours of their surgeries. The laser energy and postoperative complications were significantly lower in the Xpeeda group ( = 0.002 and  = 0.026, respectively). At 3 months, the PSA levels significantly dropped in both groups ( = 0.002 and  < 0.001). There were no significant differences in functional and sexual outcomes between the two groups at 12 months. Holmium Laser Xpeeda Vaporization and GreenLight XPS Vaporization are safe and effective in the treatment of BPH. Same-day discharge with early TOV is a feasible option. Clinical Trials.gov Identifier: NCT04386941.

摘要

比较钬激光 Xpeeda 汽化术和 GreenLight XPS 汽化术治疗前列腺体积≤80g 的前列腺增生症患者的安全性和疗效。将 92 名前列腺体积≤80g 的良性前列腺增生症(BPH)患者纳入本前瞻性随机试验。收集并比较了包括国际前列腺症状评分(IPSS)、生活质量(QoL)、尿流率、剩余尿量(PVR)、国际勃起功能指数(IIEF)-15、前列腺特异性抗原(PSA)、经直肠超声前列腺体积和导尿时间在内的结果。还记录了围手术期并发症。患者在手术后 3 小时进行了排尿试验(TOV)。所有患者在 1、3、6 和 12 个月时进行随访。两组患者的术前基线数据无统计学差异。手术参数和术后结果相当。Xpeeda 和 GreenLight XPS 组的有效即刻 TOV 分别为 73.1%和 72.7%( = 0.98)。所有患者均在手术后 24 小时内出院回家。Xpeeda 组的激光能量和术后并发症明显较低( = 0.002 和  = 0.026)。在 3 个月时,两组的 PSA 水平均显著下降( = 0.002 和  < 0.001)。两组在 12 个月时的功能和性结果无显著差异。钬激光 Xpeeda 汽化术和 GreenLight XPS 汽化术治疗 BPH 安全有效。当天出院并早期进行 TOV 是一种可行的选择。临床试验注册号:NCT04386941。

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