Shibaev A N, Podoynitsyn A A, Suleimanov R S, Pavlova Yu V, Bogatov D V, Federiakin D V, Ivkin E V, Kozlova A T, Kolontarev K B, Govorov A V, Pushkar D Yu
Department of Urology and Andrology, Tver State Medical University, Tver, Russia.
University Clinic of Tver State Medical University, Tver, Russia.
Urologiia. 2025 Jul(3):15-21.
Currently, the development of new methods of treatment of benign prostatic hyperplasia (BPH) is continuing, combining the high efficiency of transurethral resection of the prostate, which are safer for elderly patients and provide a high level of quality of life for younger patients. One of these new methods is minimally invasive water vapor thermal therapy.
To evaluate the efficiency and safety of water vapor thermal therapy in patients with lower urinary tract symptoms (LUTS)/BPH.
A total of 35 patients with LUTS/BPH who were treated between September 2022 and September 2024 (median follow-up of 12 months) were included in the study. The average age was 68.7+/-1.5 years. The prostate volume did not exceed 80 cc (52.4+/-4.2 cc). The Qmax was 9.3+/-0.7 ml/sec. The postvoid residual volume (PVR) was 73.6+/-12.2 ml. The overall IPSS score was 26.5+/-2.3 and QoL was 4.3+/-0.3. All patients were treated with water vapor thermal therapy according to the standard procedure recommended by the manufacturer (5.7+/-0.72 injections of water vapor into the prostate). The efficacy was evaluated every 3 months after the procedure. Intra- and postoperative complications were assessed on Clavien-Dindo classification.
After 3 months, 97.1% (34 out of 35) of patients had an improvement in objective urination parameters. Qmax and PVR after 3 months increased up to 17.3+/-1.5 ml/sec and 20.8+/-7.2 ml, respectively (p<0.05 compared with baseline values). There was also a significant decrease in IPSS and QoL levels, 8,5+/-1,3 and 2,3+/-0,3, respectively (p<0,05 compared with the baseline). Qmax and PVR continued to improve till the 6 months of follow-up (17.6+/-1.1ml/sec and 14.3+/-0.8 ml, respectively, p<0.05 compared with baseline and after 3 months). There was also a significant decrease in IPSS and QoL to 4.1+/-1.3 and 1.4+/-0.1 points, respectively (p<0.05 compared to 3 months). After that, these values remained stable throughout the follow-up period. The overall efficiency of the treatment (at median follow-up of 12 months) was 88,6%. Perioperative complications occurred in 9 out of 35 patients (did not exceed IIIa according to Clavien-Dindo).
Minimally invasive water vapor thermal therapy is a new effective and safe method of treating patients with LUTS/BPH. After the procedure, there is a significant improvement in lower urinary tract symptoms.
目前，良性前列腺增生（BPH）新治疗方法的研发仍在继续，这些方法结合了经尿道前列腺切除术的高效性，对老年患者更安全，为年轻患者提供了较高的生活质量。其中一种新方法是微创水蒸气热疗法。
评估水蒸气热疗法治疗下尿路症状（LUTS）/BPH患者的有效性和安全性。
本研究纳入了2022年9月至2024年9月期间接受治疗的35例LUTS/BPH患者（中位随访时间为12个月）。平均年龄为68.7±1.5岁。前列腺体积不超过80立方厘米（52.4±4.2立方厘米）。最大尿流率（Qmax）为9.3±0.7毫升/秒。排尿后残余尿量（PVR）为73.6±12.2毫升。国际前列腺症状评分（IPSS）总分是26.5±2.3，生活质量评分（QoL）是4.3±0.3。所有患者均按照制造商推荐的标准程序接受水蒸气热疗法（向前列腺内注入5.7±0.72次水蒸气）。术后每3个月评估疗效。根据Clavien-Dindo分类评估术中及术后并发症。
3个月后，97.1%（35例中的34例）患者的客观排尿参数有所改善。3个月后的Qmax和PVR分别增至17.3±1.5毫升/秒和20.8±7.2毫升（与基线值相比，p<0.05）。IPSS和QoL水平也显著下降，分别为8.5±1.3和2.3±0.3（与基线相比，p<0.05）。Qmax和PVR在随访6个月时持续改善（分别为17.6±1.1毫升/秒和14.3±0.8毫升，与基线及3个月后相比，p<0.05）。IPSS和QoL也显著降至4.1±1.3和1.4±0.1分（与3个月时相比，p<0.05）。此后，这些值在整个随访期内保持稳定。治疗的总体有效率（中位随访12个月时）为88.6%。35例患者中有9例发生围手术期并发症（根据Clavien-Dindo分类不超过Ⅲa级）。
微创水蒸气热疗法是治疗LUTS/BPH患者的一种新的有效且安全的方法。术后下尿路症状有显著改善。
