In:
Urologia Internationalis, S. Karger AG, Vol. 87, No. 4 ( 2011), p. 392-399
Abstract:
〈 i 〉 Purpose: 〈 /i 〉 A prospective randomized controlled trial was performed in elderly patients with benign prostatic hyperplasia (BPH) to evaluate the clinical effectiveness of channel transurethral resection of the prostate (C-TURP) combined with an interstitial laser coagulation (ILC) technique during a 4-year follow-up period. 〈 i 〉 Methods: 〈 /i 〉 A total of 150 consecutive BPH patients were randomized to an ILC+C-TURP group (n = 50), an ILC group (n = 50) and a TURP group (n = 50). Urinary tract infection, acute urinary retention and retrograde ejaculation were monitored, and the retreatment rate, international prostate symptom score (IPSS) and maximum flow rate (Q 〈 sub 〉 max 〈 /sub 〉 ) were measured. 〈 i 〉 Results: 〈 /i 〉 A total of 142 patients completed the follow-up and were recruited for further analysis. At 1 month, the proportion of patients with urinary tract infection was similar between the C-TURP+ILC group and the TURP group (8.5 and 6.5%, p 〉 0.05), but significantly higher than that in the ILC group (51%, p 〈 0.001). Acute urinary retention was found in 30.6% of patients in the ILC group, but was not observed in the C-TURP+ILC and TURP groups. In the TURP group, the rate of retrograde ejaculation was significantly higher than that in the other 2 groups (p 〈 0.001). The retreatment rate was 8.5, 36.7 and 2.2% in the C-TURP+ILC, ILC and TURP groups, respectively (p 〈 0.001). When compared with baseline, the IPSS in the C-TURP+ILC, ILC and TURP groups was decreased by 70.6, 45.4, and 81.0%, respectively (ILC vs. C-TURP+ILC or TURP, p 〈 0.01) at the 48-month follow-up. One month after surgery, the Q 〈 sub 〉 max 〈 /sub 〉 was significantly increased in the C-TURP+ILC group and the TURP group when compared with that at baseline (p 〈 0.01). The TURP group had the highest and the ILC group had the lowest increase in the Q 〈 sub 〉 max 〈 /sub 〉 at the 12-, 24-, and 48-month follow-ups (p 〈 0.05). 〈 i 〉 Conclusions: 〈 /i 〉 C-TURP+ILC is a safe and effective modality for the treatment of BPH, and exhibits favorable short-term clinical response and long-term durability. It is relatively reasonable and acceptable for treatment of high-risk elderly patients or those with a limited life expectancy.
Type of Medium:
Online Resource
ISSN:
0042-1138
,
1423-0399
Language:
English
Publisher:
S. Karger AG
Publication Date:
2011
detail.hit.zdb_id:
1464417-4
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