高龄高危患者良性前列腺增生微创治疗新进展

New progress in minimally invasive treatment of benign prostatic hyperplasia in elderly patients at high risk

良性前列腺增生(benign prostatic hyperplasia,BPH)是导致老年男性下尿路症状(lower urinary tract symptoms,LUTS)最常见的一种疾病,其发病率随着年龄的增长而逐渐增加。近年来治疗方案主要有药物治疗、手术治疗,但上述传统的治疗方式,在应对高龄且健康状况较差的患者时,难以达到缓解下尿路症状和改善生活质量的目的。随着医疗水平的发展,微创治疗作为一种新的治疗手段,具有创伤小、恢复快、围手术期和术后并发症发生率低、术后生活质量高等潜在优点,已经逐渐引起国内外的重视。本文就近年来兴起的前列腺动脉栓塞术(prostatic artery embolization,PAE)、前列腺段尿道悬吊术(prostatic urethral lift,PUL)、经尿道前列腺柱状水囊扩裂术(transurethral columnar balloon dilation of the prostate,TUCBDP)、前列腺支架植入术等BPH微创治疗进行综述,旨在为临床医生更好地解决高龄高危患者良性前列腺增生问题提供决策方案。

Benign prostatic hyperplasia(BPH)is the most common form of lower urinary tract symptoms(LUTS)in old men.Its incidence gradually increases with age.In recent years,the treatment mainly includes drug treatment and surgical treatment.However,the above-mentioned traditional treatment methods are difficult to achieve the purpose of relieving lower urinary tract symptoms and improving quality of life when dealing with old patients with poor health.With the development of medical level,minimally invasive treatment,as a new treatment,has potential advantages,such as small trauma,rapid recovery,less perioperative and postoperative complications,and higher quality of postoperative life.In this paper,we reviewed the minimally invasive treatment of BPH such as prostatic artery embolization(PAE),prostatic urethral lift(PUL),and transurethral columnar balloon dilation of the prostate(TUCBDP),prostate stent,in order to provide a decision-making plan for clinicians to effectively solve the problem of benign prostatic hyperplasia in old patients at high risk.