A multicenter retrospective study of transurethral prostate split for benign prostate hyperplasia.
A multicenter retrospective study of transurethral prostate split for benign prostate hyperplasia.
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DOI：
10.21037/tau-21-1138
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发表时间：
2022-03
影响因子：
2
通讯作者：
Wen J
中科院分区：
文献类型：
--
作者：
Wei J;Zhang S;Wang B;Ke M;Liu S;Yang Z;Zhou G;Qian J;Lv W;Fan Y;Shi Z;Wan L;Chen Y;He J;Liang H;Long H;Wang S;Wang H;Chen B;Shao H;Yang B;Sun C;Huangfu Q;Du C;Cai M;Wen J
经尿道前列腺电切术（TUSP）是治疗良性前列腺增生症（BPH）的有效方法。然而，仍然缺乏研究集中在TUSP的最佳目标人群。本研究旨在比较TUSP在不同前列腺体积或年龄患者中的疗效。本研究是一项多中心回顾性研究。比较不同前列腺体积和不同年龄BPH患者TUSP的疗效。共有439名患者被纳入研究。根据前列腺体积将患者分为两组，临界值为50 mL。同样，年龄组的临界值为70岁。记录基线患者特征和围手术期结局。在术后1、6和12个月进行随访。患者的平均年龄为73.4岁，平均前列腺体积为51.2 mL。TUSP治疗后12个月随访时，患者的国际前列腺症状评分（IPSS）、生活质量（QoL）评分和残余尿量（PVR）显著下降，而峰值尿流率（Qmax）显著增加。小容量组术中血红蛋白（Hb）降低显著低于大容量组。小容量组术后尿急和短暂性尿失禁的发生率较低。小容量组IPSS评分、PVR和Qmax在多个时间点与术前相比变化更显著。小容量组的术后疼痛评分高于大容量组。两组在长期并发症方面没有差异。年轻组在某些时间点的PVR和Qmax变化较大，但QoL变化较小。TUSP治疗BPH总体安全有效。本研究显示TUSP治疗不同前列腺体积或年龄的BPH患者的结局存在差异。BPH患者的最佳手术方法可能会根据前列腺体积或患者年龄的组合进行临床选择。
Transurethral split of the prostate (TUSP) is effective in treating benign prostatic hyperplasia (BPH). However, there is still a lack of research focusing on the optimal target population for TUSP. This study aimed to compare the efficacy of TUSP in patients with different prostate volumes or ages. The study was a multicenter retrospective study. The outcomes of TUSP in BPH patients with different prostate volumes or different ages were compared. A total of 439 patients were included in the study. Patients were divided into two groups according to prostate volume, with a cut-off value of 50 mL. Similarly, the cut-off value for the age groups was 70 years. Baseline patient characteristics and perioperative outcomes were recorded. Follow-up was performed at 1, 6, and 12 months after surgery. The mean age of the patients was 73.4 years, and the mean prostate volume was 51.2 mL. At 12-month follow-up after TUSP treatment, the patients’ International Prostate Symptom Scores (IPSS), quality of life (QoL) scores, and postvoid residual (PVR) volumes decreased significantly, while peak urinary flow rate (Qmax) increased significantly. Intraoperative hemoglobin (Hb) reduction was significantly lower in the small volume group than in the large volume group. The incidence of postoperative urinary urgency and transient incontinence was lower in the small volume group. IPSS score, PVR, and Qmax in the small volume group showed more remarkable changes at several time points compared to the preoperative period. Postoperative pain scores were higher in the small volume group than in the large volume group. There were no differences between the two groups in terms of long-term complications. The younger group showed greater variation in PVR and Qmax at some time points but less variation in QoL than the older group. TUSP is overall safe and effective in treating BPH. This study showed differences in the outcomes of TUSP in treating different prostate volumes or ages of BPH patients. The optimal surgical approach for BPH patients might be selected clinically based on a combination of prostate volume or patient age.
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影响因子：
23.4
作者：
Gratzke, Christian;Bachmann, Alexander;Gravas, Stavros
通讯作者：
Gravas, Stavros
影响因子：
2.6
作者：
Dornbier, Ryan;Pahouja, Gaurav;McVary, Kevin T.
通讯作者：
McVary, Kevin T.
影响因子：
2.2
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
Haleblian, George
影响因子：
23.4
作者：
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通讯作者：
Hofmann, Rainer