良性前列腺增生症微创治疗研究进展
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摘要
良性前列腺增生症(BPH)是中老年男性的常见病,其严重影响患者的生活质量及身心健康。随着人们对生活质量要求的提高,传统治疗前列腺增生的手术方式,如经尿道前列腺电切术和开放前列腺摘除术,因伴有较多并发症已无法满足当前患者的需求。近年来,激光及各种微创技术广泛应用推动了BPH微创治疗的发展。各种激光及微创技术在取得了不俗的治疗效果的同时,也显示出安全性高、快捷、出血少、对性功能影响小等优点。随着技术的进一步完善,各种激光及微创技术将更加广泛地应用于BPH的治疗。
Benign prostatic hyperplasia( BPH) is a common diseases of middle-aged and old men,which seriously affects patients' quality of life and physical and mental health. With the improvement of the quality of life,traditional treatments for prostate hyperplasia,such as transurethral resection of the prostate and open prostatectomy,have become unable to meet the needs of current patients due to frequent complications. In recent years,laser and minimally invasive technologies have promoted the development of BPH minimally invasive treatment. Various lasers and minimally invasive techniques have achieved good results in the treatment,showing the advantages of high safety,fastness,less bleeding,and little impact on sexual function. With the further improvement of technology,various laser and minimally invasive techniques will be more widely used in the treatment of BPH.
Benign prostatic hyperplasia( BPH) is a common diseases of middle-aged and old men,which seriously affects patients' quality of life and physical and mental health. With the improvement of the quality of life,traditional treatments for prostate hyperplasia,such as transurethral resection of the prostate and open prostatectomy,have become unable to meet the needs of current patients due to frequent complications. In recent years,laser and minimally invasive technologies have promoted the development of BPH minimally invasive treatment. Various lasers and minimally invasive techniques have achieved good results in the treatment,showing the advantages of high safety,fastness,less bleeding,and little impact on sexual function. With the further improvement of technology,various laser and minimally invasive techniques will be more widely used in the treatment of BPH.
引文
[1]Sivarajan G,Borofsky MS,Shah O,et al.The role of minimally invasive surgical techniques in the management of large-gland benign prostatic hypertrophy[J].Rev Urol,2015,17(3):140-149.
[2]吴阶平.吴阶平泌尿外科学[M].济南:山东科学技术出版社,2004:1127.
[3]Oelke M,Bachmann A,Descazeaud A,et al.EAU guidelines on the treatment and follow-up of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction[J].Eur Urol,2013,64(1):118-140.
[4]Netto NR Jr,de Lima ML,Netto MR,et al.Evaluation of patients with bladder outlet obstruction and mild international prostate symptom score followed up by watchful waiting[J].Urology,1999,53(2):314-316.
[5]那彦群.中国泌尿外科疾病诊断治疗指南手册:2014版[M].北京:人民卫生出版社,2014:259.
[6]Tubaro A,Carter S,Hind A,et al.A prospective study of the safety and efficacy of suprapubic transvesical prostatectomy in patients with benign prostatic hyperplasia[J].J Urol,2001,166(1):172-176.
[7]Doowy,Krajewski W,Dembowski J,et al.The role of lasers in modern urology[J].Cent European J Urol,2015,68(2):175-182.
[8]徐欢,谷猛,陈彦博,等.经尿道钬激光前列腺剜除治疗良性前列腺增生[J].中国医学装备,2016,13(10):133-136.
[9]Gilling PJ,Cass CB,Malcolm AR,et al.Combination holmium and Nd:YAG laser ablation of the prostate:Initial clinical experience[J].J Endourol,1995,9(2):151-153.
[10]Moody JA,Lingeman JE.Holmium laser enucleation for prostate adenoma greater than 100 gm.:Comparison to open prostatectomy[J].J Urol,2001,165(2):459-462.
[11]Kuntz RM,Lehrich K,Ahyai SA.Holmium laser enucleation of the prostate versus open prostatectomy for prostates greater than100 grams:5-year follow-up results of a randomised clinical trial[J].Eur Urol,2008,53(1):160-166.
[12]Kuntz RM,Ahyai S,Lehrich K,et al.Transurethral holmium laser enucleation of the prostate versus transurethral electrocautery resection of the prostate:A randomized prospective trial in 200patients[J].J Urol,2004,172(3):1012-1016.
[13]Tan AH,Gilling PJ,Kennett KM,et al.A randomized trial comparing holmium laser enucleation of the prostate with transurethral resection of the prostate for the treatment of bladder outlet obstruction secondary to benign prostatic hyperplasia in large glands(40 to 200 grams)[J].J Urol,2003,170(4 Pt 1):1270-1274.
[14]Tooher R,Sutherland P,Costello A,et al.A systematic review of holmium laser prostatectomy for benign prostatic hyperplasia[J].J Urol,2004,171(5):1773-1781.
[15]Humphreys MR,Miller NL,Handa SE,et al.Holmium laser enucleation of the prostate-outcomes independent of prostate size?[J].J Urol,2008,180(6):2431-2435.
[16]Wendt-Nordahl G,Huckele S,Honeck P,et al.Systematic evaluation of a recently introduced 2-microm continuous-wave thulium laser for vaporesection of the prostate[J].J Endourol,2008,22(5):1041-1045.
[17]Fried NM.High-power laser vaporization of the canine prostate using a 110 W Thulium fiber laser at 1.91 microm[J].Lasers Surg Med,2005,36(1):52-56.
[18]winiarski PP,StńpieńS,Dudzic W,et al.Thulium laser enucleation of the prostate(Tm LEP)vs.transurethral resection of the prostate(TURP):Evaluation of early results[J].Cent European J Urol,2012,65(3):130-134.
[19]Carmignani L,Bozzini G,Macchi A,et al.Sexual outcome of patients undergoing thulium laser enucleation of the prostate for benign prostatic hyperplasia[J].Asian J Androl,2015,17(5):802-826.
[20]Bozzini G,Seveso M,Melegari S,et al.Thulium laser enucleation(Thu LEP)versus transurethral resection of the prostate in saline(TURis):A randomized prospective trial to compare intra and early postoperative outcomes[J].Actas Urol Esp,2017,41(5):309-315.
[21]Yang Z,Wang X,Liu T.Thulium laser enucleation versus plasmakinetic resection of the prostate:A randomized prospective trial with 18-month follow-up[J].Urology,2013,81(2):396-400.
[22]Malek RS,Barrett DM,Kuntzman RS.High-power potassium-titanyl-phosphate(KTP/532)laser vaporization prostatectomy:24hours later[J].Urology,1998,51(2):254-256.
[23]Malek RS,Kuntzman RS,Barrett DM.High power potassiumtitanyl-phosphate laser vaporization prostatectomy[J].J Urol,2000,163(6):1730-1733.
[24]Chung DE,Te AE.New techniques for laser prostatectomy:An update[J].Ther Adv Urol,2009,1(2):85-97.
[25]Te AE,Malloy TR,Stein BS,et al.Photoselective vaporization of the prostate for the treatment of benign prostatic hyperplasia:12-month results from the first United States multicenter prospective trial[J].J Urol,2004,172(4 Pt 1):1404-1408.
[26]Chung DE,Wysock JS,Lee RK,et al.Outcomes and complications after 532 nm laser prostatectomy in anticoagulated patients with benign prostatic hyperplasia[J].J Urol,2011,186(3):977-981.
[27]Al-Ansari A,Younes N,Sampige VP,et al.GreenLight HPS 120W laser vaporization versus transurethral resection of the prostate for treatment of benign prostatic hyperplasia:A randomized clinical trial with midterm follow-up[J].Eur Urol,2010,58(3):349-355.
[28]Cornu JN,Ahyai S,Bachmann A,et al.A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction:An update[J].Eur Urol,2015,67(6):1066-1096.
[29]Van Cleynenbreugel B,Srirangam SJ,Van Poppel H.High-performance system GreenLight laser:Indications and outcomes[J].Curr Opin Urol,2009,19(1):33-37.
[30]Bachmann A,Tubaro A,Barber N,et al.A European multicenter randomized noninferiority trial comparing 180 W GreenLight XPSlaser vaporization and transurethral resection of the prostate for the treatment of benign prostatic obstruction:12-month results of the GOLIATH study[J].J Urol,2015,193(2):570-578.
[31]Valdivieso R,Hueber PA,Meskawi M,et al.Multicentre international experience of 532 nm laser photoselective vaporization with GreenLight XPS in men with very large prostates[J].BJU Int,2018,122(5):873-878.
[32]Ajib K,Mansour M,Zanaty M,et al.Photoselective vaporization of the prostate with the 180-W XPS-Greenlight laser:Five-year experience of safety,efficiency,and functional outcomes[J].Can Urol Assoc J,2018,12(7):E318-E324.
[33]Kahokehr AA,Gilling PJ.Which laser works best for benign prostatic hyperplasia?[J].Curr Urol Rep,2013,14(6):614-619.
[34]Wezel F,Wendt-Nordahl G,Huck N,et al.New alternatives for laser vaporization of the prostate:Experimental evaluation of a980-,1,318-and 1,470-nm diode laser device[J].World JUrol,2010,28(2):181-186.
[35]Yang SS,Hsieh CH,Lee YS,et al.Diode laser(980 nm)enucleation of the prostate:A promising alternative to transurethral resection of the prostate[J].Lasers Med Sci,2013,28(2):353-360.
[36]陈忠,马俊,杨竣,等.1 470 nm激光直出光纤TURP式前列腺汽化剜除术治疗良性前列腺增生初步报告[J].现代泌尿生殖肿瘤杂志,2015,7(1):5-8.
[37]刘春晓.经尿道前列腺腔内剜除术[J/CD].中华腔镜泌尿外科杂志(电子版),2009,3(1):25.
[38]Chen S,Zhu L,Cai J,et al.Plasmakinetic enucleation of the prostate compared with open prostatectomy for prostates larger than100 grams:A randomized noninferiority controlled trial with longterm results at 6 years[J].Eur Urol,2014,66(2):284-291.
[39]Zhao Z,Zeng G,Zhong W,et al.A prospective,randomised trial comparing plasmakinetic enucleation to standard transurethral resection of the prostate for symptomatic benign prostatic hyperplasia:Three-year follow-up results[J].Eur Urol,2010,58(5):752-758.
[40]Neill MG,Gilling PJ,Kennett KM,et al.Randomized trial comparing holmium laser enucleation of prostate with plasmakinetic enucleation of prostate for treatment of benign prostatic hyperplasia[J].Urology,2006,68(5):1020-1024.
[41]Rao JM,Xiao HJ,Ren YX,et al.Did prostate size affect the complication and outcome of plasmakinetic enucleation of the prostate?[J].Int Urol Nephrol,2014,46(11):2063-2070.
[42]梁嘉宇,卢一平.前列腺段尿道悬吊术---BPH微创治疗新方法[J].中华男科学杂志,2016,22(8):735-740.
[43]Mc Nicholas TA.Benign prostatic hyperplasia and new treatment options-a critical appraisal of the Uro Lift system[J].Med Devices(Auckl),2016,9:115-123.
[44]Ray A,Morgan H,Wilkes A,et al.The urolift system for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia:A nice medical technology guidance[J].Appl Health Econ Health Policy,2016,14(5):515-526.
[45]Roehrborn CG,Rukstalis DB,Barkin J,et al.Three year results of the prostatic urethral L.I.F.T.study[J].Can J Urol,2015,22(3):7772-7782.
[46]Perera M,Roberts MJ,Doi SA,et al.Prostatic urethral lift improves urinary symptoms and flow while preserving sexual function for men with benign prostatic hyperplasia:A systematic review and meta-analysis[J].Eur Urol,2015,67(4):704-713.
[47]Porpiglia F,Fiori C,Bertolo R,et al.Temporary implantable nitinol device(TIND):A novel,minimally invasive treatment for relief of lower urinary tract symptoms(LUTS)related to benign prostatic hyperplasia(BPH):Feasibility,safety and functional results at 1 year of follow-up[J].BJU Int,2015,116(2):278-287.
[48]Porpiglia F,Fiori C,Bertolo R,et al.3-Year follow-up of temporary implantable nitinol device implantation for the treatment of benign prostatic obstruction[J].BJU Int,2018,122(1):106-112.
[49]Bertolo R,Fiori C,Amparore D,et al.Follow-up of temporary implantable nitinol device(TIND)implantation for the treatment of BPH:A systematic review[J].Curr Urol Rep,2018,19(6):44.
[2]吴阶平.吴阶平泌尿外科学[M].济南:山东科学技术出版社,2004:1127.
[3]Oelke M,Bachmann A,Descazeaud A,et al.EAU guidelines on the treatment and follow-up of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction[J].Eur Urol,2013,64(1):118-140.
[4]Netto NR Jr,de Lima ML,Netto MR,et al.Evaluation of patients with bladder outlet obstruction and mild international prostate symptom score followed up by watchful waiting[J].Urology,1999,53(2):314-316.
[5]那彦群.中国泌尿外科疾病诊断治疗指南手册:2014版[M].北京:人民卫生出版社,2014:259.
[6]Tubaro A,Carter S,Hind A,et al.A prospective study of the safety and efficacy of suprapubic transvesical prostatectomy in patients with benign prostatic hyperplasia[J].J Urol,2001,166(1):172-176.
[7]Doowy,Krajewski W,Dembowski J,et al.The role of lasers in modern urology[J].Cent European J Urol,2015,68(2):175-182.
[8]徐欢,谷猛,陈彦博,等.经尿道钬激光前列腺剜除治疗良性前列腺增生[J].中国医学装备,2016,13(10):133-136.
[9]Gilling PJ,Cass CB,Malcolm AR,et al.Combination holmium and Nd:YAG laser ablation of the prostate:Initial clinical experience[J].J Endourol,1995,9(2):151-153.
[10]Moody JA,Lingeman JE.Holmium laser enucleation for prostate adenoma greater than 100 gm.:Comparison to open prostatectomy[J].J Urol,2001,165(2):459-462.
[11]Kuntz RM,Lehrich K,Ahyai SA.Holmium laser enucleation of the prostate versus open prostatectomy for prostates greater than100 grams:5-year follow-up results of a randomised clinical trial[J].Eur Urol,2008,53(1):160-166.
[12]Kuntz RM,Ahyai S,Lehrich K,et al.Transurethral holmium laser enucleation of the prostate versus transurethral electrocautery resection of the prostate:A randomized prospective trial in 200patients[J].J Urol,2004,172(3):1012-1016.
[13]Tan AH,Gilling PJ,Kennett KM,et al.A randomized trial comparing holmium laser enucleation of the prostate with transurethral resection of the prostate for the treatment of bladder outlet obstruction secondary to benign prostatic hyperplasia in large glands(40 to 200 grams)[J].J Urol,2003,170(4 Pt 1):1270-1274.
[14]Tooher R,Sutherland P,Costello A,et al.A systematic review of holmium laser prostatectomy for benign prostatic hyperplasia[J].J Urol,2004,171(5):1773-1781.
[15]Humphreys MR,Miller NL,Handa SE,et al.Holmium laser enucleation of the prostate-outcomes independent of prostate size?[J].J Urol,2008,180(6):2431-2435.
[16]Wendt-Nordahl G,Huckele S,Honeck P,et al.Systematic evaluation of a recently introduced 2-microm continuous-wave thulium laser for vaporesection of the prostate[J].J Endourol,2008,22(5):1041-1045.
[17]Fried NM.High-power laser vaporization of the canine prostate using a 110 W Thulium fiber laser at 1.91 microm[J].Lasers Surg Med,2005,36(1):52-56.
[18]winiarski PP,StńpieńS,Dudzic W,et al.Thulium laser enucleation of the prostate(Tm LEP)vs.transurethral resection of the prostate(TURP):Evaluation of early results[J].Cent European J Urol,2012,65(3):130-134.
[19]Carmignani L,Bozzini G,Macchi A,et al.Sexual outcome of patients undergoing thulium laser enucleation of the prostate for benign prostatic hyperplasia[J].Asian J Androl,2015,17(5):802-826.
[20]Bozzini G,Seveso M,Melegari S,et al.Thulium laser enucleation(Thu LEP)versus transurethral resection of the prostate in saline(TURis):A randomized prospective trial to compare intra and early postoperative outcomes[J].Actas Urol Esp,2017,41(5):309-315.
[21]Yang Z,Wang X,Liu T.Thulium laser enucleation versus plasmakinetic resection of the prostate:A randomized prospective trial with 18-month follow-up[J].Urology,2013,81(2):396-400.
[22]Malek RS,Barrett DM,Kuntzman RS.High-power potassium-titanyl-phosphate(KTP/532)laser vaporization prostatectomy:24hours later[J].Urology,1998,51(2):254-256.
[23]Malek RS,Kuntzman RS,Barrett DM.High power potassiumtitanyl-phosphate laser vaporization prostatectomy[J].J Urol,2000,163(6):1730-1733.
[24]Chung DE,Te AE.New techniques for laser prostatectomy:An update[J].Ther Adv Urol,2009,1(2):85-97.
[25]Te AE,Malloy TR,Stein BS,et al.Photoselective vaporization of the prostate for the treatment of benign prostatic hyperplasia:12-month results from the first United States multicenter prospective trial[J].J Urol,2004,172(4 Pt 1):1404-1408.
[26]Chung DE,Wysock JS,Lee RK,et al.Outcomes and complications after 532 nm laser prostatectomy in anticoagulated patients with benign prostatic hyperplasia[J].J Urol,2011,186(3):977-981.
[27]Al-Ansari A,Younes N,Sampige VP,et al.GreenLight HPS 120W laser vaporization versus transurethral resection of the prostate for treatment of benign prostatic hyperplasia:A randomized clinical trial with midterm follow-up[J].Eur Urol,2010,58(3):349-355.
[28]Cornu JN,Ahyai S,Bachmann A,et al.A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction:An update[J].Eur Urol,2015,67(6):1066-1096.
[29]Van Cleynenbreugel B,Srirangam SJ,Van Poppel H.High-performance system GreenLight laser:Indications and outcomes[J].Curr Opin Urol,2009,19(1):33-37.
[30]Bachmann A,Tubaro A,Barber N,et al.A European multicenter randomized noninferiority trial comparing 180 W GreenLight XPSlaser vaporization and transurethral resection of the prostate for the treatment of benign prostatic obstruction:12-month results of the GOLIATH study[J].J Urol,2015,193(2):570-578.
[31]Valdivieso R,Hueber PA,Meskawi M,et al.Multicentre international experience of 532 nm laser photoselective vaporization with GreenLight XPS in men with very large prostates[J].BJU Int,2018,122(5):873-878.
[32]Ajib K,Mansour M,Zanaty M,et al.Photoselective vaporization of the prostate with the 180-W XPS-Greenlight laser:Five-year experience of safety,efficiency,and functional outcomes[J].Can Urol Assoc J,2018,12(7):E318-E324.
[33]Kahokehr AA,Gilling PJ.Which laser works best for benign prostatic hyperplasia?[J].Curr Urol Rep,2013,14(6):614-619.
[34]Wezel F,Wendt-Nordahl G,Huck N,et al.New alternatives for laser vaporization of the prostate:Experimental evaluation of a980-,1,318-and 1,470-nm diode laser device[J].World JUrol,2010,28(2):181-186.
[35]Yang SS,Hsieh CH,Lee YS,et al.Diode laser(980 nm)enucleation of the prostate:A promising alternative to transurethral resection of the prostate[J].Lasers Med Sci,2013,28(2):353-360.
[36]陈忠,马俊,杨竣,等.1 470 nm激光直出光纤TURP式前列腺汽化剜除术治疗良性前列腺增生初步报告[J].现代泌尿生殖肿瘤杂志,2015,7(1):5-8.
[37]刘春晓.经尿道前列腺腔内剜除术[J/CD].中华腔镜泌尿外科杂志(电子版),2009,3(1):25.
[38]Chen S,Zhu L,Cai J,et al.Plasmakinetic enucleation of the prostate compared with open prostatectomy for prostates larger than100 grams:A randomized noninferiority controlled trial with longterm results at 6 years[J].Eur Urol,2014,66(2):284-291.
[39]Zhao Z,Zeng G,Zhong W,et al.A prospective,randomised trial comparing plasmakinetic enucleation to standard transurethral resection of the prostate for symptomatic benign prostatic hyperplasia:Three-year follow-up results[J].Eur Urol,2010,58(5):752-758.
[40]Neill MG,Gilling PJ,Kennett KM,et al.Randomized trial comparing holmium laser enucleation of prostate with plasmakinetic enucleation of prostate for treatment of benign prostatic hyperplasia[J].Urology,2006,68(5):1020-1024.
[41]Rao JM,Xiao HJ,Ren YX,et al.Did prostate size affect the complication and outcome of plasmakinetic enucleation of the prostate?[J].Int Urol Nephrol,2014,46(11):2063-2070.
[42]梁嘉宇,卢一平.前列腺段尿道悬吊术---BPH微创治疗新方法[J].中华男科学杂志,2016,22(8):735-740.
[43]Mc Nicholas TA.Benign prostatic hyperplasia and new treatment options-a critical appraisal of the Uro Lift system[J].Med Devices(Auckl),2016,9:115-123.
[44]Ray A,Morgan H,Wilkes A,et al.The urolift system for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia:A nice medical technology guidance[J].Appl Health Econ Health Policy,2016,14(5):515-526.
[45]Roehrborn CG,Rukstalis DB,Barkin J,et al.Three year results of the prostatic urethral L.I.F.T.study[J].Can J Urol,2015,22(3):7772-7782.
[46]Perera M,Roberts MJ,Doi SA,et al.Prostatic urethral lift improves urinary symptoms and flow while preserving sexual function for men with benign prostatic hyperplasia:A systematic review and meta-analysis[J].Eur Urol,2015,67(4):704-713.
[47]Porpiglia F,Fiori C,Bertolo R,et al.Temporary implantable nitinol device(TIND):A novel,minimally invasive treatment for relief of lower urinary tract symptoms(LUTS)related to benign prostatic hyperplasia(BPH):Feasibility,safety and functional results at 1 year of follow-up[J].BJU Int,2015,116(2):278-287.
[48]Porpiglia F,Fiori C,Bertolo R,et al.3-Year follow-up of temporary implantable nitinol device implantation for the treatment of benign prostatic obstruction[J].BJU Int,2018,122(1):106-112.
[49]Bertolo R,Fiori C,Amparore D,et al.Follow-up of temporary implantable nitinol device(TIND)implantation for the treatment of BPH:A systematic review[J].Curr Urol Rep,2018,19(6):44.