Early Experiences of Contact Laser Vaporization of the Prostate using the 980nm High Power Diode Laser for Benign Prostatic Hyperplasia
Early Experiences of Contact Laser Vaporization of the Prostate using the 980nm High Power Diode Laser for Benign Prostatic Hyperplasia
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DOI：
10.1111/luts.12173
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发表时间：
2018-09-01
影响因子：
1.3
通讯作者：
Homma, Yukio
中科院分区：
文献类型：
--
作者：
Miyazaki, Hideyo;Hirano, Yoshikazu;Homma, Yukio
目的报告接触式激光前列腺汽化术治疗症状性良性前列腺增生症(BPH)的早期经验。方法2013年4月至2014年9月，在日本4个机构招募80例患者，采用980 nm高功率半导体激光器，在接触模式下使用端射光纤进行接触式激光前列腺汽化。结果在符合条件的76例患者中，(84.2%)在24周时国际前列腺症状评分下降超过50%(95%可信区间：74.0~91.6%)，清除了经尿道前列腺电切术前的非劣势疗效水平(65%)。术后12周和24周，症状评分、最大尿流率、排尿后残余尿量和前列腺体积均有显著改善。围手术期并发症包括一过性尿潴留20例，逆行射精5例，膀胱颈痉挛4例，尿路狭窄3例，前列腺床结石3例，膀胱结石2例，膀胱穿孔1例，膀胱畸形1例，一过性尿失禁1例。尿潴留和膀胱颈痉挛几乎完全发生在一家机构。24周时观察到的症状评分、最大尿流率和排尿后残余尿量在1年和2年后基本保持不变。结论日本早期接触式激光汽化手术的疗效与24周时经尿道前列腺电切术的疗效相当。该手术的长期疗效仍不确定。
ObjectivesWe report early experiences of contact laser vaporization of the prostate for symptomatic benign prostatic hyperplasia (BPH).MethodsA total of 80 patients recruited at four institutions in Japan from April 2013 through September 2014 underwent contact laser vaporization of the prostate using 980nm high power diode laser with an end-firing fiber in the contact mode. Patients were followed prospectively at 1day, 2, 4, 8, 12, and 24weeks, postoperatively per protocol, and at 1 and 2years post-protocol.ResultsOf 76 eligible patients, 64 (84.2%) achieved more than 50% decrease in International Prostate Symptom Score at 24weeks (95% confidence interval: 74.0-91.6%), clearing the pre-fixed non-inferiority efficacy level to transurethral resection of the prostate (65%). Symptom scores, maximum flow rate, post-void residual urine, and prostate volume showed significant improvements at 12 and 24weeks after the surgery. Perioperative complications included transient urinary retention (n=20), retrograde ejaculation (5), bladder neck contracture (4), urethral stricture (3), stone in prostatic bed (3), bladder stone (2), bladder perforation (1), bladder deformity (1), and transient urgency incontinence (1). Urinary retention and bladder neck contracture occurred almost exclusively at one institution. Improved symptom scores, maximum flow rate, and post-void residual urine observed at 24weeks remained virtually unchanged at 1 and 2years.ConclusionsEarly experience of contact laser vaporization in Japan showed efficacy comparable to transurethral resection of the prostate as a surgical procedure for BPH at 24weeks. Long-term efficacy of the procedure remains uncertain.