Desgrandchamps F, Tobolski F, Oudart E, Teillac P, Le Duc A
Service d'Urologie, Hôpital Saint-Louis, Paris.
Prog Urol. 1995 Jun;5(3):390-6.
To evaluate the clinical and endoscopic effects of transrectal focal ultrasound (Sonablate) on benign prostatic hypertrophy.
This was a phase II study, performed in 13 patients with benign prostatic hypertrophy. Patients were evaluated before treatment, and 45 days and 90 days after treatment by means of a symptom score (1-PSS), uroflowmetry, estimation of prostatic volume by transrectal ultrasonography, and urethroprostatic endoscopy. A transducer with a focal length of 3.5 cm was used in 12 patients. One patient was treated with a transducer with a focal length of 3 cm. We used an acoustic energy level at the focal point of 1,680 W/cm2 for the last two patients.
With a follow-up of 3 months, the symptom score was only moderately improved (decreasing from 20 +/- 7 to 14 +/- 9, p < 0.03), with no improvement of uroflowmetry and tissue destruction was not demonstrated on endoscopy in any of the patients.
The therapeutic applications of focal ultrasound thermotherapy are potentially very vast, but, up until now, have only rarely exceeded the experimental stage. Our data emphasize that future developments are essential before this technology can be included in therapeutic alternatives for benign prostatic hypertrophy.
评估经直肠聚焦超声（Sonablate）治疗良性前列腺增生的临床及内镜效果。
这是一项II期研究，纳入13例良性前列腺增生患者。在治疗前、治疗后45天和90天，通过症状评分（1 - PSS）、尿流率测定、经直肠超声评估前列腺体积以及尿道前列腺内镜检查对患者进行评估。12例患者使用焦距为3.5 cm的换能器。1例患者使用焦距为3 cm的换能器。最后2例患者在焦点处使用的声能水平为1680 W/cm²。
随访3个月时，症状评分仅得到中度改善（从20±7降至14±9，p < 0.03），尿流率未改善，且内镜检查未显示任何患者有组织破坏。
聚焦超声热疗的治疗应用潜力巨大，但迄今为止，很少能超越实验阶段。我们的数据强调，在该技术可纳入良性前列腺增生的治疗选择之前，未来的发展至关重要。
