前列腺肥大患者的水蒸气热疗(Rezūm 系统):一项前瞻性比较研究的结果。

IF 4.9 2区 医学 Q1 UROLOGY & NEPHROLOGY Minerva Urology and Nephrology Pub Date : 2024-11-04 DOI:10.23736/S2724-6051.24.05883-X
Raffaele Balsamo, Simone Tammaro, Massimiliano Trivellato, Felice Crocetto, Biagio Barone, Ferdinando Fusco, Davide Arcaniolo, Celeste Manfredi, Luca Cindolo, Raffaele Ranavolo, Francesco Uricchio
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引用次数: 0

摘要

背景:Rezūm是一种新型微创外科技术(MIST),适用于药物治疗难治的中等尺寸前列腺(30-80 cm3)良性前列腺增生症患者。本研究的目的是评估 Rezūm 作为大型前列腺(大于 80 立方厘米)治疗方案的有效性和安全性:方法:我们在 2022 年 6 月至 2023 年 6 月期间进行了一项前瞻性、比较性、单中心研究,包括使用 Rezūm 系统进行手术的连续患者。入组男性根据前列腺大小分为两个亚组:中型前列腺(MP)(30-80 cm3)和大型前列腺(LP)(≥80 cm3)。纳入标准包括国际前列腺症状评分(IPSS)总分≥ 8 分。在基线、术后 3 个月、6 个月和 12 个月收集国际前列腺症状评分 (IPSS)、最大尿流率 (Qmax)、排尿后残余物 (PVR) 和国际勃起功能指数 5 项版 (IIEF-5)。在 3 个月时评估是否存在射精。术后并发症采用克拉维恩-丁多(Clavien-Dindo,CD)分类法进行描述。主要结果是IPSS-总分,次要结果是术中和术后CD≥III级并发症:研究共纳入121例患者(PV 78.2±32.1 mL),其中51例为大型前列腺(LP),70例为中型前列腺(MP)。IPSS-总分和 Qmax 显示出显著的统计学意义(PConclusions:Rezūm水蒸气疗法似乎能有效治疗较大前列腺的良性前列腺增生症。此外,该疗法损害性功能的风险较低,表明其安全性良好。
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Water vapor thermal therapy (Rezūm System) in patients with large prostates: results from a prospective comparative study.

Background: Rezūm is a novel minimally invasive surgical technique (MIST) useful for BPH patients with medium-sized prostate (30-80 cm3) refractory to medical treatment. The aim of this study was to evaluate the efficacy and safety of Rezūm as a treatment option in large-sized prostates (>80 cm3).

Methods: We performed a prospective, comparative, single-center study from June 2022 to June 2023, including consecutive patients undergoing surgery with the Rezūm System. Enrolled men were classified into two subgroups based on prostate size: medium prostate (MP) (30-80 cm3) and large prostate (LP) (≥80 cm3). Inclusion criteria included an International Prostate Symptom Score (IPSS) Total score of ≥ 8 points. International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), post-void residual (PVR), and International Index of Erectile Function 5-item version (IIEF-5) were collected at baseline and at three, six, and 12 months post-procedure. Ejaculation presence was assessed at 3 months. Post-operative complications were described using the Clavien-Dindo (CD) classification. The primary outcome was the IPSS-Total score, with intraoperative and postoperative CD grade ≥III complications as secondary outcomes.

Results: One hundred and twenty-one patients (PV 78.2±32.1 mL) were included in the study, 51 large prostate (LP) and 70 medium prostate (MP). The IPSS-Total score and Qmax showed a statistically significant (P<0.0001) improvement at 3, 6, and 12 months respectively. PVR decreased at 3, 6, and 12 months; however, only at 3 months this variation was statistically significant (P<0.0001). At 3-month follow-up, anejaculation was detected in (3; 5.8% and 1; 1.4%) patients in LP and MP group respectively (P=0.86). IIEF-5 significantly improved 3 months after surgery in the LP subgroup (P<0.0001).

Conclusions: Rezūm water vapor therapy appears to be effective for treating BPH in larger prostates. Additionally, it demonstrates a low risk of impairing sexual function, indicating a favorable safety profile.

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来源期刊
Minerva Urology and Nephrology
Minerva Urology and Nephrology UROLOGY & NEPHROLOGY-
CiteScore
8.50
自引率
32.70%
发文量
237
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