Narayan P, Tewari A, Garzotto M, Parramore H W, Schalow E, Starling J, Jones T
University of Florida School of Medicine, Gainesville, USA.
Urology. 1996 Apr;47(4):505-10. doi: 10.1016/S0090-4295(99)80485-3.
This is a study to evaluate technique, efficacy, and safety of a new electrosurgical instrument (Vaportrode) in management of benign prostatic hyperplasia (BPH).
Forty-two symptomatic BPH patients form the subject of this study. Preoperative and postoperative International Prostate Symptom Score (IPSS), peak flow rates (PFR), postvoid residual urine (PVR), operative details, and complications were recorded in each patient. Baseline, 1, 3, and 6 months follow-up data were used for analyses.
Results reveal that transurethral electrovaporization of the prostate (TUEVP) is a reasonable procedure to treat symptomatic BPH, and at 6 months, this procedure results in 68% reduction in IPSS, 128% improvement in PFR, and 58% reduction in PVR. Even in patients who are in retention prior to TUEVP, at 6 months the IPSS is 7.7, PFR is 20.4 cc/s, and PVR reduces to 130 cc. The procedure is well tolerated without any significant short-term complications.
The results of this modality in improving the symptoms and PFR in symptomatic BPH patients in the short term appear promising. Advantages over transurethral resection (TUR) of the prostate and laser prostatectomy include familiarity of the transurethral route, lack of need for high-cost laser equipment and fibers, excellent intraoperative hemostasis, lack of bleeding or fluid absorption, and ability to cause a predictable TUR-like prostate defect at the end of the procedure. Further studies involving larger numbers of patients and longer follow-up are warranted to assess further the utility of this procedure.
本研究旨在评估一种新型电外科器械（Vaportrode）治疗良性前列腺增生（BPH）的技术、疗效及安全性。
42例有症状的BPH患者纳入本研究。记录每位患者术前及术后的国际前列腺症状评分（IPSS）、最大尿流率（PFR）、残余尿量（PVR）、手术细节及并发症。采用基线、1、3和6个月随访数据进行分析。
结果显示，经尿道前列腺电汽化术（TUEVP）是治疗有症状BPH的合理方法，6个月时，该手术使IPSS降低68%，PFR提高128%，PVR降低58%。即使是术前潴留的患者，6个月时IPSS为7.7，PFR为20.4 cc/s，PVR降至130 cc。该手术耐受性良好，无任何明显短期并发症。
这种方法在短期内改善有症状BPH患者症状和PFR方面的结果似乎很有前景。与经尿道前列腺切除术（TUR）和激光前列腺切除术相比，其优点包括经尿道途径熟悉、无需高成本激光设备及光纤、术中止血良好、无出血或液体吸收，且在手术结束时能形成可预测的类似TUR的前列腺缺损。有必要进行涉及更多患者和更长随访时间的进一步研究，以进一步评估该手术的实用性。
