Kato Taiki, Chaya Ryosuke, Sugino Teruaki, Ota Yuya, Taguchi Kazumi, Hamakawa Takashi, Kubota Yasue, Maruyama Tetsuji, Yasui Takahiro
Department of Nephro-urology, Nagoya City University.
Department of Urology, Tokyo Adventist Hospital, Suginami.
Nihon Hinyokika Gakkai Zasshi. 2024;115(3):116-123. doi: 10.5980/jpnjurol.115.116.
(Introduction and objective) Water vapor energy therapy (WAVE) received insurance approval in Japan in September 2022 for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia. Here we report a prospective trial of WAVE. (Patients and methods) This study included 16 patients who underwent WAVE between November 2022 and December 2023. International Prostate Symptom Score (IPSS), IPSS Quality of Life (QOL) score, overactive bladder symptom score, post-void residual urine volume (PVR), prostate volume (PV) measured using transrectal ultrasonography, postoperative catheter removal rate, surgical duration, and adverse events were recorded preoperatively and at 1, 3, 6, and 12 months postoperative. (Results) The median age was 76.5 years, and 11 of 16 patients (69%) received antiplatelets and/or anticoagulants. The median preoperative PV was 43.5 ml, while the median postoperative follow-up period was 6.9 months. Comparison of the baseline and 6-month postoperative follow-up values showed that the median IPSS and IPSS-QOL scores decreased significantly (by 48% and 55%, respectively), while the median PV was significantly reduced by 36%. The median PVR was reduced by 51%; however, the difference was not significant. Catheter removal was successful in 80% of patients. The median surgical duration was 8.5 min (range, 4.0-26.0 min). Complications (grade ≤ II) according to the Common Terminology Criteria for Adverse Events v5.0 occurred in 12 patients. (Conclusion) WAVE is a useful minimally invasive surgical approach in elderly patients and patients receiving antiplatelets and/or anticoagulants, featuring a short surgical duration, improved micturition, and no serious adverse events.
（引言与目的）水蒸气能量疗法（WAVE）于2022年9月在日本获得保险批准，用于治疗良性前列腺增生继发的下尿路症状。在此，我们报告一项WAVE的前瞻性试验。（患者与方法）本研究纳入了2022年11月至2023年12月期间接受WAVE治疗的16例患者。记录术前以及术后1个月、3个月、6个月和12个月时的国际前列腺症状评分（IPSS）、IPSS生活质量（QOL）评分、膀胱过度活动症症状评分、排尿后残余尿量（PVR）、经直肠超声测量的前列腺体积（PV）、术后导尿管拔除率、手术时长以及不良事件。（结果）中位年龄为76.5岁，16例患者中有11例（69%）接受抗血小板和/或抗凝治疗。术前PV的中位数为43.5 ml，术后中位随访期为6.9个月。基线值与术后6个月随访值比较显示，IPSS和IPSS-QOL评分中位数显著降低（分别降低48%和55%），而PV中位数显著降低36%。PVR中位数降低了51%；然而，差异无统计学意义。80%的患者成功拔除导尿管。中位手术时长为8.5分钟（范围4.0 - 26.0分钟）。根据不良事件通用术语标准v5.0，12例患者发生并发症（≤II级）。（结论）WAVE是一种对老年患者以及接受抗血小板和/或抗凝治疗的患者有用的微创手术方法，具有手术时间短、排尿改善且无严重不良事件的特点。
