良性前列腺增生症患者前列腺钬激光去核术疗效不佳的术前预测因素。

IF 1.5 4区 医学 Q3 UROLOGY & NEPHROLOGY LUTS: Lower Urinary Tract Symptoms Pub Date : 2024-07-16 DOI:10.1111/luts.12530
Kyohei Watanabe, Atsushi Otsuka, Yuichi Kitagawa, Asuka Sano, Ryo Sato, Yuto Matsushita, Hiromitsu Watanabe, Keita Tamura, Daisuke Motoyama, Toshiki Ito, Sanki Takada, Hideaki Miyake
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引用次数: 0

摘要

研究目的我们评估了良性前列腺增生症(BPH)患者接受前列腺钬激光去核术(HoLEP)疗效不佳的术前预测因素:本研究纳入了2015年8月至2021年6月期间在我院接受HoLEP术的159例患者。根据国际前列腺症状评分(IPSS)、IPSS生活质量(IPSS-QOL)和最大尿流率的变化,将总体疗效分为疗效好和疗效差。根据HoLEP术后3个月的结果将患者分为疗效好和疗效差两组,并对两组进行比较评估:结果:159 名患者中有 53 人(33.3%)的 HoLEP 疗效不佳。疗效差组的膀胱内前列腺突出(IPP)、IPSS、IPSS-QOL、排尿后残余尿量(PVR)和膀胱过度活动症(OAB)明显高于疗效好组。对多个因素进行的多变量分析表明,术前存在膀胱过度活动症和IPP短是导致HoLEP疗效不佳的独立风险因素。根据风险因素对疗效进行划分后发现,只有14%的患者IPP时间长且无OAB,疗效较差:结论:对于 OAB 和 IPP 较短的患者,HoLEP 的疗效可能较差,导致下尿路症状明显恶化。因此,在选择 HoLEP 的适应症时,必须考虑是否存在 OAB 和 IPP 测量值。
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Preoperative factors predicting poor therapeutic efficacy of holmium laser enucleation of the prostate in patients with benign prostatic hyperplasia

Objectives

We assessed preoperative factors predicting the poor therapeutic efficacy of holmium laser enucleation of the prostate (HoLEP) in benign prostatic hyperplasia (BPH) patients.

Methods

The present study included 159 patients who underwent HoLEP between August 2015 and June 2021 at our institution. Overall therapeutic efficacy was divided into good and poor therapeutic efficacies according to changes in the international prostate symptom score (IPSS), IPSS quality of life (IPSS-QOL), and the maximum urinary flow rate. Patients were divided into good and poor therapeutic efficacy groups based on findings obtained 3 months after HoLEP, and comparative assessments were performed between the two groups.

Results

The therapeutic efficacy of HoLEP was poor in 53 (33.3%) out of 159 patients. Intravesical prostatic protrusion (IPP), IPSS, IPSS-QOL, post-void residual volume (PVR), and the presence of overactive bladder (OAB) were significantly higher in the poor therapeutic efficacy group than in the good therapeutic efficacy group. A multivariable analysis of several factors identified the preoperative presence of OAB and short IPP as independent risk factors for the poor therapeutic efficacy of HoLEP. When treatment efficacy was divided according to risk factors, poor therapeutic efficacy was observed in only 14% of patients with prolonged IPP and the absence of OAB.

Conclusions

The therapeutic efficacy of HoLEP may be poor in patients with OAB and short IPP, resulting in the significant deterioration of lower urinary tract symptoms. Accordingly, it is important to consider the presence or absence of OAB and IPP measurements when selecting indications for HoLEP.

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来源期刊
LUTS: Lower Urinary Tract Symptoms
LUTS: Lower Urinary Tract Symptoms UROLOGY & NEPHROLOGY-
CiteScore
3.00
自引率
7.70%
发文量
52
审稿时长
>12 weeks
期刊介绍: LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided. LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.
期刊最新文献
Safety and Effectiveness of Vibegron in Japanese Patients With Overactive Bladder: A Japanese Postmarketing Survey Correction to "Preoperative Factors Predicting Poor Therapeutic Efficacy of Holmium Laser Enucleation of the Prostate in Patients With Benign Prostatic Hyperplasia". Issue Information Efficacy and Safety of Lemborexant for Insomnia Patients With Nocturia—A Prospective Study Issue Information
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