Akpala Anna, Lezama Tamara, Hussain Mushtaq, Jinadu Kehinde, Parker Tia, Sreenivasan Sahana, Manandhar Amar
Urology, Queen Elizabeth Hospital Birmingham, Birmingham, GBR.
Cardiac Surgery, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, GBR.
Cureus. 2024 Dec 12;16(12):e75579. doi: 10.7759/cureus.75579. eCollection 2024 Dec.
Benign prostatic hyperplasia (BPH) is the enlargement and overgrowth of the prostate leading to the compression of the urethra and resulting in obstruction to the outflow of urine. Prostatic urethral lift (UroLift) is a budding minimally invasive technique that utilises mechanical manipulation of the prostate tissue so that the urethra is free from compression, thereby creating a channel for the outflow of urine. The aim of the audit was to assess the short- to medium-term outcomes in our centre in terms of improvement in symptoms, quality of life (QoL) and complication rates.
A retrospective observational study was employed. All patients who had UroLift procedure between December 2021 and December 2022 were included.
Sixty-four patients were found for the chosen period. Age ranged between 48 and 91 with a mean age of 73. The average prostate size was 48.63 g (31-50 g). Of the patients, 64% (n=41) had the procedure performed under general anaesthesia, whilst the rest had either regional or local anaesthesia or entonox. Two to eight clips were used per patient, with four being the median number of clips. Furthermore, 53.13% (n=34) had a catheter post-procedure, with 52.94% (n=18) of these achieving trial without catheter (TWOC) in less than seven days. Of the patients, 67.18% (n=43) had no complications, 7.8% (n=5) went into acute urinary retention requiring short-term catheterisation, 1.56% (n=1) had bleeding requiring blood transfusion and 6.25% (n=4) had infection. Overall, 17.18% (n=11) had failure of procedure requiring other forms of intervention for BPH at two years post-operatively. The median improvement in post-void residual scan and quality of life (QoL) scores were 58 mL and 1.5, respectively.
Although transurethral resection of the prostate (TURP) remains the gold standard surgical treatment for BPH, UroLift offers a less minimally invasive approach with better short-term recovery, preservation of sexual function and low complication profile. The failure rate from UroLift from previous studies falls within the range of 7%-22%, and the figures attained in our centre are comparable to these.
良性前列腺增生（BPH）是前列腺的增大和过度生长，导致尿道受压，从而造成尿液流出受阻。前列腺尿道悬吊术（UroLift）是一种新兴的微创技术，它通过对前列腺组织进行机械操作，使尿道不再受压，从而为尿液流出创造通道。本次审计的目的是评估我们中心在症状改善、生活质量（QoL）和并发症发生率方面的短期至中期结果。
采用回顾性观察研究。纳入2021年12月至2022年12月期间接受UroLift手术的所有患者。
在选定期间共找到64例患者。年龄在48岁至91岁之间，平均年龄为73岁。平均前列腺大小为48.63克（31 - 50克）。其中，64%（n = 41）的患者在全身麻醉下进行手术，其余患者接受区域麻醉、局部麻醉或笑气麻醉。每位患者使用2至8个夹子，中位数为4个夹子。此外，53.13%（n = 34）的患者术后留置导尿管，其中52.94%（n = 18）的患者在不到7天内实现了拔管试验（TWOC）。在这些患者中，67.18%（n = 43）没有并发症，7.8%（n = 5）出现急性尿潴留，需要短期导尿，1.56%（n = 1）出现出血需要输血，6.25%（n = 4）出现感染。总体而言，17.18%（n = 11）的患者手术失败，术后两年需要对BPH采取其他形式的干预。排尿后残余尿量扫描和生活质量（QoL）评分的中位数改善分别为58毫升和1.5。
尽管经尿道前列腺切除术（TURP）仍然是BPH的金标准手术治疗方法，但UroLift提供了一种侵入性较小的方法，具有更好的短期恢复、性功能保留和低并发症发生率。先前研究中UroLift的失败率在7% - 22%范围内，我们中心获得的数据与这些数据相当。
