Arai Y, Ishitoya S, Okubo K, Suzuki Y
Department of urology, Kurashiki Central Hospital, Japan.
Br J Urol. 1996 Jul;78(1):93-8. doi: 10.1046/j.1464-410x.1996.04018.x.
To assess the efficacy and safety of transurethral interstitial laser coagulation (ILC) in the treatment of benign prostatic hyperplasia (BPH).
From December 1993 to March 1995, 61 patients (mean age 69.7 years, range 55-89) with symptomatic BPH were treated with ILC. A neodymium: YAG laser was used in combination with specially designed interstitial thermotherapy light-guides. The tip of the light guide was inserted repeatedly into each lobe of the prostate transurethrally, under direct vision. The number of fibre placements depended on the size and configuration of the gland. The prostatic urethra was preserved during the procedure. Treatment outcome was evaluated using the International Prostatic Symptom Score (IPSS), measurement of urinary flow rate and post-void residual urine volume (PVR). The disease-specific quality of life (QOL) was assessed using a QOL assessment score and a BPH impact index. Independently of the symptom assessment, a self-reporting questionnaire was completed 3 months after treatment to determine the patients' satisfaction with the treatment and their sexual function.
Among the 31 patients followed for 6 months, the mean IPSS decreased significantly, from 18.9 at baseline to 7.7 (59% improvement; P < 0.001), the mean peak flow rate increased from 6.7 mL/s to 10.0 mL/s (49% improvement; n = 29; P < 0.001), the mean PVR decreased from 119 mL to 29 mL (76% improvement; n = 28, P < 0.001) and the mean prostate volume decreased significantly, from 37.1 mL to 31.6 mL (15% reduction at 3 months; n = 52, P < 0.001). There was a steady and progressive improvement in both the QOL assessment and the BPH impact index scores at 3 and 6 months. More than 90% of the patients reported satisfaction with the treatment and none reported the new onset of erectile dysfunction. There were no serious side-effects, except for two cases of loss of ejaculation.
The early clinical results suggest that the ILC procedure is a safe and effective less-invasive treatment for BPH that appears to have favourable effects on the patients' quality of life.
评估经尿道间质激光凝固术（ILC）治疗良性前列腺增生（BPH）的疗效和安全性。
1993年12月至1995年3月，61例有症状的BPH患者接受了ILC治疗。使用钕:钇铝石榴石激光与专门设计的间质热疗光导纤维联合使用。在直视下，将光导纤维尖端经尿道反复插入前列腺的每个叶。纤维放置的数量取决于腺体的大小和形态。手术过程中保留前列腺尿道。使用国际前列腺症状评分（IPSS）、尿流率测量和排尿后残余尿量（PVR）评估治疗效果。使用生活质量评估评分和BPH影响指数评估疾病特异性生活质量（QOL）。独立于症状评估，在治疗3个月后完成一份自我报告问卷，以确定患者对治疗的满意度及其性功能。
在随访6个月的31例患者中，平均IPSS显著下降，从基线时的18.9降至7.7（改善59%；P<0.001），平均最大尿流率从6.7 mL/s增至10.0 mL/s（改善49%；n = 29；P<0.001），平均PVR从119 mL降至29 mL（改善76%；n = 28，P<0.001），平均前列腺体积显著减小，从37.1 mL降至31.6 mL（3个月时减少15%；n = 52，P<0.001）。在3个月和6个月时，QOL评估和BPH影响指数评分均有稳定且逐步的改善。超过90%的患者报告对治疗满意，且无一例报告新发勃起功能障碍。除2例射精功能丧失外，无严重副作用。
早期临床结果表明，ILC手术是一种安全有效的BPH微创治疗方法，似乎对患者的生活质量有良好影响。
