Aim： To explore the feasibility and safety of greenlight photoselective vaporization of the prostate （PVP） on high-risk patients presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplas...Aim： To explore the feasibility and safety of greenlight photoselective vaporization of the prostate （PVP） on high-risk patients presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplasia （BPH） and to evaluate their clinical and voiding outcome. Methods： A total of 85 high-risk patients with obstructive BPH underwent PVP with an 80 W potassium-titanyl-phosphate laser, which was delivered through a side-deflecting fiber with a 23 Fr continuous flow cystoscope. Operative time, blood loss, indwelling catheterzation, international prostate symptom score （IPSS）, quality of life score （QoL）, uroflowmetry, postvoid residual urine volume and short-term complication rates were evaluated for all patients. Results： All patients got through the perioperative period safely. The chief advantages of PVP were： short operative time （25.6 ± 7.6 min）, little bleeding loss （56.8 ± 14.3 mL） and short indwelling catheterization （1.6 ± 0.8 d）. The IPSS and QoL decreased from （29.6 ± 5.4） and （5.4 ± 0.6） to （9.5 ± 2.6） and （1.3 ± 0.6）, respectively. The vast majority of patients were satisfied with voiding outcome. The mean maximal urinary flow rate increased to 17.8 mL/s and postvoid residual urine volume decreased to 55.6 mL. These results are significantly different from preoperative data （P 〈 0.05）. No patient required blood transfusion or fluid absorption. There were few complications and very high patient satisfaction after operation. Conclusion： PVP has a short operative time and high tolerance, and is safe, effective and minimally invasive for high-risk patients, therefore it might be considered as a good alternative treatment for high-risk patients with obstructive urinary symptoms as a result of BPH.展开更多
Aim:To explore the feasibility and safely of greenlight photoselective vaporization of the prostate(PVP)on high-risk patients presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplasia(BPH...Aim:To explore the feasibility and safely of greenlight photoselective vaporization of the prostate(PVP)on high-risk patients presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplasia(BPH)and to evalu- ate their clinical and voiding outcome.Methods:A total of 85 high-risk patients with obstructive BPH underwent PVP with an 80W potassium-titanyl-phosphate laser,which was delivered through a side-deflecting fiber with a 23 Fr continuous flow cystoscope.Operative time,blood loss,indwelling catheterzation,international prostate symptom score(IPSS),quality of life score(QoL),uroflowmetry,postvoid residual urine volume and short-term complication rates were evaluated for all patients.Results:All patients got through the perioperative period safely.The chief advantages of PVP were:short operative time(25.6±7.6min),little bleeding loss(56.8±14.3mL)and short indwelling catheterization(1.6±0.8d).The IPSS and QoL decreased from(29.6±5.4)and(5.4±0.6)to(9.5±2.6)and(1.3± 0.6),respectively.The vast majority of patients were satisfied with voiding outcome.The mean maximal urinary flow rate increased to 17.8 roLls and postvoid residual urine volume decreased to 55.6mL.These results are signifi- cantly different from preoperative data(P<0.05).No patient required blood transfusion or fluid absorption.There were few complications and very high patient satisfaction after operation.Conclusion:PVP has a short operative time and high tolerance,and is safe,effective and minimally invasive for high-risk patients,therefore it might be considered as a good alternative treatment for high-risk patients with obstructive urinary symptoms as a result of BPH.展开更多
目的研究经尿道绿激光汽化术(photoselective vaporization of the prostate,PVP)联合双极等离子电切术(bipolar plasmakinetic resection of the prostate,PKRP)治疗良性前列腺增生(benign prostatic hyperplasia,BPH)的临床疗效和应...目的研究经尿道绿激光汽化术(photoselective vaporization of the prostate,PVP)联合双极等离子电切术(bipolar plasmakinetic resection of the prostate,PKRP)治疗良性前列腺增生(benign prostatic hyperplasia,BPH)的临床疗效和应用价值。方法以2017年1月~2019年12月在西部战区总医院诊治的123例BPH患者为研究对象,按手术方式分为PKRP组(n=61)、PVP+PKRP组(n=62),比较两组围手术期临床指标,同时观察在高龄(≥70岁)、大体积(≥80 ml)患者中的疗效。结果 PVP+PKRP组较PKRP组在术中出血量、术后留置尿管时间、住院时间具有显著优势(P <0.05),两组术后6个月国际前列腺症状评分(international prostate symptom score,IPSS)、生活质量(quality of life,QoL)、最大尿流率(the maximum flow rate,Qmax)均较术前明显改善(P <0.05),两组术后并发症发生率无显著差异。在高龄、大体积前列腺分组中,术中出血量、术后带管天数及住院天数也表现出明显优势(P <0.05)。结论 PVP联合PKRP治疗BPH安全有效,相较于单纯PKRP,可减少术中出血和术后带管时间,术后恢复较快,对于高龄大体积BPH患者亦适用。展开更多
目的探讨经尿道选择性绿激光前列腺汽化术(photoselective vaporization of the prostate,PVP)治疗良性前列腺增生(benign prostatic hyperplasia,BPH)的安全性与临床疗效。方法采用骶管阻滞麻醉,对650例BPH行PVP。利用光纤头部的红色...目的探讨经尿道选择性绿激光前列腺汽化术(photoselective vaporization of the prostate,PVP)治疗良性前列腺增生(benign prostatic hyperplasia,BPH)的安全性与临床疗效。方法采用骶管阻滞麻醉,对650例BPH行PVP。利用光纤头部的红色瞄准光点定位操作,汽化时先从膀胱颈部6点开始至5~7点,然后汽化两侧叶,深度达前列腺包膜。结果5例(0.8%)因前列腺体积大、出血多改行开放手术。645例PVP手术时间(45.6±17.3)min;术中出血量(56.3±15.2)ml,无输血病例;5.04例术后留置尿管(1.8±0.5)d。术后随访3~36个月,国际前列腺症状评分及生活质量评分由术前(29.8±5.2)分及(5.2±0.8)分下降至术后3个月(8.4±2.3)分(t=37.635,P=0.000)及(1.4±0.5)分(t=39.084,P=0.000),残余尿量由术前(168.0±22.5)ml下降至术后3个月(24.6±5.8)ml(t=42.281,P=0.000),最大尿流率由术前(5.6±2.8)ml/s增加至术后3个月(24.7...展开更多
目的:对比研究120 W绿激光前列腺汽化术(PVP)在不同良性前列腺增生(BPH)患者群体中的疗效及安全性。方法:对2013年7月至2014年9月于我科诊断为BPH并行120 W PVP的患者,按前列腺体积(PV)(<80 ml和≥80 ml)、有无服用5-α还原酶抑制剂(...目的:对比研究120 W绿激光前列腺汽化术(PVP)在不同良性前列腺增生(BPH)患者群体中的疗效及安全性。方法:对2013年7月至2014年9月于我科诊断为BPH并行120 W PVP的患者,按前列腺体积(PV)(<80 ml和≥80 ml)、有无服用5-α还原酶抑制剂(5-ARIs)(持续时间>1个月)以及有无既往急性尿潴留史(AUR)进行分组对照研究,观察记录术前及围手术期情况,并于术后1、3个月随访。结果:共174例患者纳入研究,38例患者术中转为经尿道前列腺电切术(TURP),其余136例患者顺利完成手术并随访至术后3个月。患者年龄(69.4±7.7)岁,术前PV(67.9±29.8)ml,手术时间(49.4±16.3)min。术中无输血、电切综合征及前列腺包膜穿孔发生,术后2例患者发生尿道狭窄、2例患者出现膀胱颈口挛缩。各组患者的术后疗效指标均较术前显著提高,且各对照组间(大体积前列腺组与非大体积前列腺组、5-ARIs服用组与5-ARIs未服用组、AUR病史组与无AUR病史组)无统计学差异。结论:120 W PVP治疗BPH安全有效,且疗效不受PV、术前是否规律服用5-ARIs、既往有无AUR史影响,但术前留置导尿管可能增加手术难度及术中中转TURP的风险。展开更多
文摘Aim： To explore the feasibility and safety of greenlight photoselective vaporization of the prostate （PVP） on high-risk patients presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplasia （BPH） and to evaluate their clinical and voiding outcome. Methods： A total of 85 high-risk patients with obstructive BPH underwent PVP with an 80 W potassium-titanyl-phosphate laser, which was delivered through a side-deflecting fiber with a 23 Fr continuous flow cystoscope. Operative time, blood loss, indwelling catheterzation, international prostate symptom score （IPSS）, quality of life score （QoL）, uroflowmetry, postvoid residual urine volume and short-term complication rates were evaluated for all patients. Results： All patients got through the perioperative period safely. The chief advantages of PVP were： short operative time （25.6 ± 7.6 min）, little bleeding loss （56.8 ± 14.3 mL） and short indwelling catheterization （1.6 ± 0.8 d）. The IPSS and QoL decreased from （29.6 ± 5.4） and （5.4 ± 0.6） to （9.5 ± 2.6） and （1.3 ± 0.6）, respectively. The vast majority of patients were satisfied with voiding outcome. The mean maximal urinary flow rate increased to 17.8 mL/s and postvoid residual urine volume decreased to 55.6 mL. These results are significantly different from preoperative data （P 〈 0.05）. No patient required blood transfusion or fluid absorption. There were few complications and very high patient satisfaction after operation. Conclusion： PVP has a short operative time and high tolerance, and is safe, effective and minimally invasive for high-risk patients, therefore it might be considered as a good alternative treatment for high-risk patients with obstructive urinary symptoms as a result of BPH.
文摘Aim:To explore the feasibility and safely of greenlight photoselective vaporization of the prostate(PVP)on high-risk patients presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplasia(BPH)and to evalu- ate their clinical and voiding outcome.Methods:A total of 85 high-risk patients with obstructive BPH underwent PVP with an 80W potassium-titanyl-phosphate laser,which was delivered through a side-deflecting fiber with a 23 Fr continuous flow cystoscope.Operative time,blood loss,indwelling catheterzation,international prostate symptom score(IPSS),quality of life score(QoL),uroflowmetry,postvoid residual urine volume and short-term complication rates were evaluated for all patients.Results:All patients got through the perioperative period safely.The chief advantages of PVP were:short operative time(25.6±7.6min),little bleeding loss(56.8±14.3mL)and short indwelling catheterization(1.6±0.8d).The IPSS and QoL decreased from(29.6±5.4)and(5.4±0.6)to(9.5±2.6)and(1.3± 0.6),respectively.The vast majority of patients were satisfied with voiding outcome.The mean maximal urinary flow rate increased to 17.8 roLls and postvoid residual urine volume decreased to 55.6mL.These results are signifi- cantly different from preoperative data(P<0.05).No patient required blood transfusion or fluid absorption.There were few complications and very high patient satisfaction after operation.Conclusion:PVP has a short operative time and high tolerance,and is safe,effective and minimally invasive for high-risk patients,therefore it might be considered as a good alternative treatment for high-risk patients with obstructive urinary symptoms as a result of BPH.
文摘目的研究经尿道绿激光汽化术(photoselective vaporization of the prostate,PVP)联合双极等离子电切术(bipolar plasmakinetic resection of the prostate,PKRP)治疗良性前列腺增生(benign prostatic hyperplasia,BPH)的临床疗效和应用价值。方法以2017年1月~2019年12月在西部战区总医院诊治的123例BPH患者为研究对象,按手术方式分为PKRP组(n=61)、PVP+PKRP组(n=62),比较两组围手术期临床指标,同时观察在高龄(≥70岁)、大体积(≥80 ml)患者中的疗效。结果 PVP+PKRP组较PKRP组在术中出血量、术后留置尿管时间、住院时间具有显著优势(P <0.05),两组术后6个月国际前列腺症状评分(international prostate symptom score,IPSS)、生活质量(quality of life,QoL)、最大尿流率(the maximum flow rate,Qmax)均较术前明显改善(P <0.05),两组术后并发症发生率无显著差异。在高龄、大体积前列腺分组中,术中出血量、术后带管天数及住院天数也表现出明显优势(P <0.05)。结论 PVP联合PKRP治疗BPH安全有效,相较于单纯PKRP,可减少术中出血和术后带管时间,术后恢复较快,对于高龄大体积BPH患者亦适用。
文摘目的探讨经尿道选择性绿激光前列腺汽化术(photoselective vaporization of the prostate,PVP)治疗良性前列腺增生(benign prostatic hyperplasia,BPH)的安全性与临床疗效。方法采用骶管阻滞麻醉,对650例BPH行PVP。利用光纤头部的红色瞄准光点定位操作,汽化时先从膀胱颈部6点开始至5~7点,然后汽化两侧叶,深度达前列腺包膜。结果5例(0.8%)因前列腺体积大、出血多改行开放手术。645例PVP手术时间(45.6±17.3)min;术中出血量(56.3±15.2)ml,无输血病例;5.04例术后留置尿管(1.8±0.5)d。术后随访3~36个月,国际前列腺症状评分及生活质量评分由术前(29.8±5.2)分及(5.2±0.8)分下降至术后3个月(8.4±2.3)分(t=37.635,P=0.000)及(1.4±0.5)分(t=39.084,P=0.000),残余尿量由术前(168.0±22.5)ml下降至术后3个月(24.6±5.8)ml(t=42.281,P=0.000),最大尿流率由术前(5.6±2.8)ml/s增加至术后3个月(24.7...
文摘目的:对比研究120 W绿激光前列腺汽化术(PVP)在不同良性前列腺增生(BPH)患者群体中的疗效及安全性。方法:对2013年7月至2014年9月于我科诊断为BPH并行120 W PVP的患者,按前列腺体积(PV)(<80 ml和≥80 ml)、有无服用5-α还原酶抑制剂(5-ARIs)(持续时间>1个月)以及有无既往急性尿潴留史(AUR)进行分组对照研究,观察记录术前及围手术期情况,并于术后1、3个月随访。结果:共174例患者纳入研究,38例患者术中转为经尿道前列腺电切术(TURP),其余136例患者顺利完成手术并随访至术后3个月。患者年龄(69.4±7.7)岁,术前PV(67.9±29.8)ml,手术时间(49.4±16.3)min。术中无输血、电切综合征及前列腺包膜穿孔发生,术后2例患者发生尿道狭窄、2例患者出现膀胱颈口挛缩。各组患者的术后疗效指标均较术前显著提高,且各对照组间(大体积前列腺组与非大体积前列腺组、5-ARIs服用组与5-ARIs未服用组、AUR病史组与无AUR病史组)无统计学差异。结论:120 W PVP治疗BPH安全有效,且疗效不受PV、术前是否规律服用5-ARIs、既往有无AUR史影响,但术前留置导尿管可能增加手术难度及术中中转TURP的风险。
