Amón Sesmero J H, Martínez-Sagarra Oceja J M, Estebanez Zarranz J, Rodríguez Toves A, Del Río Domínguez F, Velasco M C, Conde Redondo C
Servicio de Urología, Hospital Universitario Río Hortega, Valladolid.
Actas Urol Esp. 1998 Jun;22(6):490-7; discussion 498.
Presentation of the results obtained using the intraprostatic prosthesis UroLume in 78 patients wit BPH obstruction, 69 of which presented high surgical risk (ASA IV). Mean age was 79.8 years (r: 62-93). All patients carried urethral catheters, except 4 (5.1%) who had a provisional metal coil that required replacement. Prosthesis were implanted successfully in 72 cases (93.3%). The most significant exclusion criterion was an excessive length of prostate urethra. Mean follow-up was 15.3 months (r: 3-38). Mean maximum flow at 1 year after implant was 12.7 mL/sec; mean symptoms score (I-PSS score) was 6.2 points and in most prosthesis, epithelization had taken place. Three patients required implant of another prosthesis, either during the same surgical procedure (1 case) or later due to retention or dysuria (2 cases). Due to acute urine retention (AUR) during the immediate postoperative, resection of the middle lobe was performed in one case while a second case required late resection of intraluminal hyperplastic tissue. Three patients (4.1%) had haematuria that forced hospital admission some months after the implant, and three cases (4.1%) required removal of the prosthesis; at patient's request (1 case), due to calcification (1 case) and for stress incontinence (1 case). After a follow-up of over three years, it can be concluded that the UroLume prosthesis is an effective alternative to TUR in patients at high surgical risk.
78例良性前列腺增生梗阻患者使用前列腺内支架UroLume的结果呈现,其中69例具有高手术风险(美国麻醉医师协会IV级)。平均年龄为79.8岁(范围:62 - 93岁)。除4例(5.1%)留置临时金属线圈且需要更换外,所有患者均留置尿道导管。72例(93.3%)成功植入支架。最主要的排除标准是前列腺尿道过长。平均随访时间为15.3个月(范围:3 - 38个月)。植入后1年的平均最大尿流率为12.7 mL/秒;平均症状评分(国际前列腺症状评分)为6.2分,且大多数支架已发生上皮化。3例患者需要再次植入支架,1例在同一次手术过程中,另外2例因尿潴留或排尿困难在之后进行。术后即刻因急性尿潴留,1例进行了中叶切除术,另1例需要后期切除腔内增生组织。3例(4.1%)患者出现血尿,在植入数月后需住院治疗,3例(4.1%)患者需要取出支架,其中1例因患者要求,1例因钙化,1例因压力性尿失禁。经过三年多的随访,可以得出结论,UroLume支架对于高手术风险患者是经尿道前列腺电切术的一种有效替代方法。