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经尿道前列腺电汽化术:一年经验

Transurethral electrovaporization of the prostate: one-year experience.

作者信息

Kaplan S A, Santarosa R P, Te A E

机构信息

Department of Urology, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA.

出版信息

Urology. 1996 Dec;48(6):876-81. doi: 10.1016/s0090-4295(96)00487-6.

Abstract

OBJECTIVES

To determine the safety and efficacy of transurethral electrovaporization of the prostate (TVP) in men with lower urinary tract symptoms.

METHODS

A prospective trial of 114 consecutive patients who underwent TVP since August 1994 was conducted. The mean follow-up period was 12.3 months. Parameters evaluated included American Urological Association symptom score (Sx), peak urinary flow rate (Qmax), operative time, postoperative catheterization time, length of hospital stay, and loss of days from work.

RESULTS

Of the 109 men available for follow-up, Sx decreased from 16.7 to 7.3, 6.5, 6.3, and 5.4 at 3, 6, 12, and 18 months, respectively (P < 0.001), whereas Qmax increased from 7.9 to 14.8, 15.6, 16.7, and 16.5 mL/s at 3, 6, 12, and 18 months, respectively (P < 0.001). Mean catheterization time was 10.4 hours; mean hospital period was 0.9 days, and average loss of days from work was 5.6. Complications included intermittent postoperative hematuria in 65 patients (57%). Clot retention in 6 (5%), and bulbar urethral stricture in 2 (2%). Of 74 men who were potent preoperatively, none had postoperative erectile dysfunction; retrograde ejaculation was noted in 62 (84%). Significant postoperative irritative symptoms were reported in 10 men (9%).

CONCLUSIONS

On the basis of 1-year follow-up data, this study demonstrates that TVP is a safe and effective modality for treating lower urinary tract symptoms. However, longer, prospective, blinded studies are needed to determine efficacy relative to transurethral resection of the prostate.

摘要

目的

确定经尿道前列腺电汽化术(TVP)治疗下尿路症状男性患者的安全性和有效性。

方法

对自1994年8月起连续接受TVP的114例患者进行前瞻性试验。平均随访期为12.3个月。评估的参数包括美国泌尿外科学会症状评分(Sx)、最大尿流率(Qmax)、手术时间、术后导尿时间、住院时间以及误工天数。

结果

在109例可供随访的男性患者中,Sx在3、6、12和18个月时分别从16.7降至7.3、6.5、6.3和5.4(P < 0.001),而Qmax在3、6、12和18个月时分别从7.9增至14.8、15.6、16.7和16.5 mL/s(P < 0.001)。平均导尿时间为10.4小时;平均住院时间为0.9天,平均误工天数为5.6天。并发症包括65例患者(57%)术后间歇性血尿。6例(5%)出现血块潴留,2例(2%)出现球部尿道狭窄。在74例术前有性功能的男性患者中,无一例术后出现勃起功能障碍;62例(84%)出现逆行射精。10例男性患者(9%)报告有明显的术后刺激性症状。

结论

基于1年的随访数据,本研究表明TVP是治疗下尿路症状的一种安全有效的方法。然而,需要进行更长时间、前瞻性、盲法研究以确定与经尿道前列腺切除术相比的疗效。

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