Minimally invasive therapies for benign prostatic hyperplasia
Minimally invasive therapies for benign prostatic hyperplasia
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DOI：
10.1007/s00345-002-0283-2
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发表时间：
2002-09-01
影响因子：
3.4
通讯作者：
Evans, CP
中科院分区：
文献类型：
--
作者：
Tunuguntla, HSGR;Evans, CP
在过去的十年中，许多微创疗法已经被研究用于治疗由良性前列腺增生（BPH）引起的下尿路症状。其中大多数是利用热能来消融前列腺。然而，缺乏长期疗效、安全性和再治疗率是所有这些治疗形式的主要问题。微创治疗介于药物治疗和经尿道前列腺切除术（TURP）之间。研究表明，其中一些疗法经得起时间的考验，再治疗率低，住院时间短，但可以接受。经尿道针刺消融（TUNA）和高能经尿道微波热疗（HE-TUMT）等治疗有效缓解症状，发病率低。激光前列腺切除术由于切除/汽化缓慢和困难而不常用。微创治疗对使用抗凝剂的患者特别有用，其中麻醉是禁忌的，以及性生活活跃的年轻男性。然而，这些装置尚未在大规模对照试验中与TURP进行比较，因此，在了解其症状缓解的长期持久性之前，它们无法取代TURP。
A number of minimally invasive therapies have been studied in the last decade for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia (BPH). Most of these utilize thermal energy to ablate the prostate. Paucity of long-term efficacy, safety and re-treatment rates are, however, the main concerns of all these forms of treatment. Minimally invasive therapies can be positioned between pharmacotherapy and transurethral resection of the prostate (TURP). Studies have shown that some of these therapies stand the test of time, with low and acceptable re-treatment rates and shorter hospital stay. Therapies such as transurethral needle ablation (TUNA) and high energy transurethral microwave thermotherapy (HE-TUMT) effectively relieve symptoms with less morbidity. Laser prostatectomy is less commonly used due to the slow and difficult resection/vaporization. Minimally invasive therapies are particularly useful in those on anticoagulants, in whom anesthesia is contraindicated and younger men with an active sex life. However, these devices have not been compared with TURP in large-scale controlled trials and, therefore, will not be able to replace TURP until their long-term durability of symptom relief is known.