Kabalin J N, Gill H S, Bite G
Section of Urology, Palo Alto Veterans Affairs Medical Center, Stanford, California, USA.
J Urol. 1995 May;153(5):1502-5.
A total of 50 patients with symptomatic bladder outlet obstruction due to benign prostatic hyperplasia was entered into a prospective trial of laser prostatectomy performed with the right-angle firing neodymium:YAG laser fiber at 60 watts power setting. Mean estimated resectable prostatic weight was 30 gm. with a mean prostatic urethral length of 3.3 cm. Nine patients (18%) were in urinary retention requiring catheterization before treatment. Mean energy delivery was 30,834 joules (range 14,400 to 127,800) with a mean operative time of 31 minutes. Efficacy of treatment was assessed at 3, 6 and 12 months postoperatively by standardized American Urological Association symptom scores, peak urinary flow rates and post-void residual urine volumes. At preoperative baseline the mean symptom score was 20.8, mean peak urinary flow rate 7.6 cc per second, and mean post-void residual urine volume 353 cc. At 1 year postoperatively mean symptom score was 8.4, mean peak urinary flow rate was 18.7 cc per second and mean post-void residual urine volume was 175 cc. Two patients required retreatment for residual tissue. There were 6 complications including 5 bladder neck contractures requiring incision (10%) and 1 case of postoperative prostatitis requiring antibiotic therapy (2%). Of 37 evaluable sexually active patients 31 (84%) reported preservation of antegrade ejaculation postoperatively.
共有50例因良性前列腺增生导致有症状性膀胱出口梗阻的患者进入一项前瞻性试验，该试验采用功率设置为60瓦的直角发射钕:钇铝石榴石激光纤维进行激光前列腺切除术。估计可切除前列腺的平均重量为30克，前列腺尿道平均长度为3.3厘米。9例患者（18%）在治疗前因尿潴留需要导尿。平均能量传递为30,834焦耳（范围为14,400至127,800），平均手术时间为31分钟。在术后3个月、6个月和12个月时，通过标准化的美国泌尿外科学会症状评分、最大尿流率和排尿后残余尿量来评估治疗效果。术前基线时，平均症状评分为20.8，平均最大尿流率为每秒7.6毫升，平均排尿后残余尿量为353毫升。术后1年，平均症状评分为8.4，平均最大尿流率为每秒18.7毫升，平均排尿后残余尿量为175毫升。2例患者因残留组织需要再次治疗。有6例并发症，包括5例需要切开的膀胱颈挛缩（10%）和1例需要抗生素治疗的术后前列腺炎（2%）。在37例可评估的性活跃患者中，31例（84%）报告术后顺行射精功能得以保留。
