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经钬激光前列腺剜除术后患者的短期术后恢复:下尿路症状对生活质量影响的评估。

Short-term postoperative recovery for patients after Thulium Laser Vapoenucleation of Prostate: evaluation of the impact of lower urinary tract symptoms on quality of life.

机构信息

Department of Urology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Wujin Road No.85, Hongkou District, Shanghai, China.

Department of Pathology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

出版信息

World J Urol. 2024 Oct 23;42(1):587. doi: 10.1007/s00345-024-05293-7.

DOI:10.1007/s00345-024-05293-7
PMID:39441315
Abstract

PURPOSE

We evaluated short-term postoperative recovery in patients with benign prostatic hyperplasia (BPH), especially focusing on symptoms reduction and life quality enhancement.

METHODS

We prospectively enrolled 160 BPH patients who underwent surgery and were followed up regularly for 12 weeks, collecting the International Prostate Symptom Score (IPSS), Quality of Life (QoL), and Qmax. Regression analysis and mixed effect models were used to evaluate the tendency of symptoms on recovery from the perspective of quality of life.

RESULTS

At 12 weeks, all patients recovered well with conspicuous change in IPSS, QoL and Qmax, that were 4.80 ± 4.59, 1.34 ± 1.14,20.02 ± 8.61 mL/s respectively. Voiding symptoms were significantly reduced by 79.4% at 2 weeks, whereas storage symptoms recovered slowly until 12 weeks with residual lower urinary tract symptoms (LUTS), predominantly urinary frequency and nocturia. Improvements in incomplete emptying urination and urinary frequency were significantly associated with QoL.

CONCLUSIONS

With regards to the comprehensive full-cycle treatment of LUTS patients, in addition to the objective results, more attention should also be focused on the change in following symptoms, that is, incomplete emptying urination, urine frequency and urination difficulty, which play key roles in the enhancement of patients' quality of life.

摘要

目的

我们评估了良性前列腺增生(BPH)患者的短期术后恢复情况,特别是关注症状缓解和生活质量的提高。

方法

我们前瞻性地招募了 160 名接受手术治疗的 BPH 患者,并定期随访 12 周,收集国际前列腺症状评分(IPSS)、生活质量(QoL)和最大尿流率(Qmax)。回归分析和混合效应模型用于从生活质量的角度评估症状恢复的趋势。

结果

12 周时,所有患者均恢复良好,IPSS、QoL 和 Qmax 显著改善,分别为 4.80±4.59、1.34±1.14 和 20.02±8.61ml/s。排尿症状在 2 周时显著减轻了 79.4%,而储存症状恢复缓慢,直到 12 周仍有残余下尿路症状(LUTS),主要是尿频和夜尿。排尿不尽和尿频的改善与 QoL 显著相关。

结论

在 LUTS 患者的综合全周期治疗中,除了客观结果外,还应更加关注未完全排空、尿频和排尿困难等症状的变化,这些症状对患者生活质量的提高起着关键作用。

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本文引用的文献

1
Underactive Bladder and Detrusor Underactivity: New Advances and Prospectives.膀胱过度活动症和逼尿肌活动低下:新进展与展望。
Int J Mol Sci. 2023 Oct 24;24(21):15517. doi: 10.3390/ijms242115517.
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Modeling study of the effect of placebo and medical therapy on storage and voiding symptoms, nocturia, and quality of life in men with prostate enlargement at risk for progression.前列腺增生进展风险男性的储存和排尿症状、夜尿症和生活质量的安慰剂和医学治疗效果的建模研究。
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Does Preoperative Bladder Compliance Affect Long-Term Functional Outcomes after Laser Prostatectomy?
术前膀胱顺应性是否会影响前列腺激光切除术后的长期功能结果?
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Health-related quality of life among Chinese primary care patients with different lower urinary tract symptoms: a latent class analysis.中文初级保健患者不同下尿路症状的健康相关生活质量:潜在类别分析。
Qual Life Res. 2021 May;30(5):1305-1315. doi: 10.1007/s11136-020-02731-y. Epub 2021 Jan 14.
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Detrusor underactivity influences the efficacy of TURP in patients with BPO.逼尿肌活动低下影响 BPO 患者 TURP 的疗效。
Int Urol Nephrol. 2021 May;53(5):835-841. doi: 10.1007/s11255-020-02750-1. Epub 2021 Jan 2.
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Grading Severity and Bother Using the International Prostate Symptom Score and International Consultation on Incontinence Questionnaire Male Lower Urinary Tract Symptoms Score in Men Seeking Lower Urinary Tract Symptoms Therapy.在寻求下尿路症状治疗的男性中,使用国际前列腺症状评分和国际尿失禁咨询问卷男性下尿路症状评分来分级严重程度和困扰。
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7
Four-Year Impact of Voiding and Storage Symptoms in Patients with Benign Prostatic Hyperplasia Treated with Prostatic Artery Embolization.前列腺动脉栓塞术治疗良性前列腺增生症患者排尿及储尿症状的四年影响
J Vasc Interv Radiol. 2020 Sep;31(9):1460-1466. doi: 10.1016/j.jvir.2019.08.034. Epub 2020 Feb 24.
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Nocturia: The Complex Role of the Heart, Kidneys, and Bladder.夜尿症:心脏、肾脏和膀胱的复杂作用。
Eur Urol Focus. 2020 May 15;6(3):534-536. doi: 10.1016/j.euf.2019.07.007. Epub 2019 Aug 5.
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Surgical Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline Amendment 2019.《良性前列腺增生所致下尿路症状的外科治疗:2019 年 AUA 指南修订版》
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Detrusor Underactivity and the Underactive Bladder: A Systematic Review of Preclinical and Clinical Studies.逼尿肌活动低下和功能低下性膀胱:临床前和临床研究的系统评价。
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