Quality of life after photo-selective vaporization and holmium-laser enucleation of the prostate: 5-year outcomes
Quality of life after photo-selective vaporization and holmium-laser enucleation of the prostate: 5-year outcomes
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DOI：
10.1038/s41598-019-44686-2
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发表时间：
2019-06-04
影响因子：
4.6
通讯作者：
Cho, Min Chul
中科院分区：
文献类型：
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作者：
Sun, Inyoung;Yoo, Sangjun;Cho, Min Chul
本研究旨在比较良性前列腺增生 (BPH) 患者使用 120W 高性能系统的光选择汽化术 (PVP) 和钬激光剜除术 (HoLEP) 术后长期生活质量 (QoL) 的变化，并确定影响术后短期、中期和长期随访中生活质量改善的因素。我们分析了 1,193 名基线 QoL 指数 >= 2 且接受 PVP (n = 439) 或 HoLEP (n = 754) 的患者。使用国际前列腺症状评分 (I-PSS)、尿流率测定和血清 PSA 对两组的手术结果进行长达 60 个月的连续比较。我们使用逻辑回归分析来确定手术后短期（12 个月）、中期（36 个月）和长期（60 个月）随访中生活质量改善的预测因素（与基线相比，生活质量指数降低 >= 50%）。与基线相比，两组的生活质量指数在整个随访期间均有所下降。除 60 个月外，在 48 个月的随访期间，两组术后相对于基线生活质量指数的变化没有显着差异。 HoLEP 后 60 个月的生活质量改善程度大于 PVP 后。较低的基线储存症状子评分和较高的膀胱出口梗阻指数（BOOI）是影响短期生活质量改善的独立因素。没有独立因素影响中长期生活质量的改善。
This study was aimed to compare serial long-term postoperative changes in quality-of-life (QoL) between photoselective-vaporization (PVP) using 120W-High-Performance-System and holmium-laser-enucleation (HoLEP) in benign-prostatic-hyperplasia (BPH) patients and to identify factors influencing the QoL improvement at the short-term, mid-term and long-term follow-up visits after surgery. We analyzed 1,193 patients with a baseline QoL-index >= 2 who underwent PVP (n = 439) or HoLEP (n = 754). Surgical outcomes were serially compared between the two groups at up to 60-months using the International-Prostatic-Symptom-Score (I-PSS), uroflowmetry, and serum PSA. We used logistic regression analysis to identify predictors of QoL improvement (a reduction in the QoL-index >= 50% compared with baseline) at the short-term (12-months), mid-term (36-months), and long term (60-months) follow-up after surgery. In both groups, the QoL-index was decreased throughout the entire follow-up period compared with that at baseline. There were no significant differences in postoperative changes from the baseline QoL-index between the two groups during the 48-month follow-up, except at 60-months. The degree of improvement in QoL at 60-months after HoLEP was greater than that after PVP. A lower baseline storage-symptom-subscore and a higher bladder-outlet-obstruction-index (BOOI) were independent factors influencing QoL improvement at the short-term. No independent factor influences QoL improvement at the mid- or long-term.