Uchida T, Egawa S, Iwamura M, Ohori M, Yokoyama E, Endo T, Koshiba K
Department of Urology, School of Medicine, Kitasato University, Sagamihara, Japan.
Int J Urol. 1996 Mar;3(2):108-12. doi: 10.1111/j.1442-2042.1996.tb00493.x.
Transurethral resection of the prostate (TURP) has been the preferred surgical treatment for benign prostatic hyperplasia (BPH) for the past 50 years. Alternative methods for treating BPH such as visual laser ablation (VLAP) have been established during the past decade. In order to assess the safety and efficacy of VLAP, this alternative method was performed using a Urolase fiber and neodymium: yttrium-aluminum-garnet laser, and compared to results obtained in patients treated with TURP for BPH.
In this non-randomized comparative study, 100 BPH patients were equally split between treatment with VLAP or TURP, and their cases compared. The efficacy was assessed using an International Prostate Symptom Score, urinary flow rates, post-void residual urinary volume and an estimated prostate volume.
There was a clinically significant improvement in all parameters in both groups. In the VLAP and TURP groups, 92.0% and 81.6%, 90.2% and 86.2 and 93.1% and 100.0% were categorized as effectively-treated cases at 3, 6 and 12 months post-operatively, respectively. No severe side effect was seen in VLAP group. The total and post-operative lengths of hospitalization in the VLAP group were shorter, but the duration of post-operative bladder irrigation was longer in these patients.
Although TURP remains the standard surgical treatment for BPH, VLAP is associated with less morbidity and the clinical outcome is similar compared to patients treated with TURP. VLAP in conjunction with TURP may result in less risk of postoperative urinary retention and vesical irritability.
在过去的50年里,经尿道前列腺切除术(TURP)一直是良性前列腺增生(BPH)的首选手术治疗方法。在过去十年中,已经确立了诸如可视激光消融术(VLAP)等治疗BPH的替代方法。为了评估VLAP的安全性和有效性,使用Urolase光纤和钕:钇铝石榴石激光进行了这种替代方法,并与接受TURP治疗BPH的患者的结果进行了比较。
在这项非随机对照研究中,100例BPH患者被平均分为接受VLAP或TURP治疗两组,并对他们的病例进行比较。使用国际前列腺症状评分、尿流率、排尿后残余尿量和估计前列腺体积来评估疗效。
两组所有参数均有临床显著改善。在VLAP组和TURP组中,术后3、6和12个月分别有92.0%和81.6%、90.2%和86.2%以及93.1%和100.0%被归类为有效治疗病例。VLAP组未观察到严重副作用。VLAP组的总住院时间和术后住院时间较短,但这些患者的术后膀胱冲洗持续时间较长。
虽然TURP仍然是BPH的标准手术治疗方法,但与接受TURP治疗的患者相比,VLAP的发病率较低,临床结果相似。VLAP联合TURP可能会降低术后尿潴留和膀胱刺激的风险。