증상이 있는 전립선비대증환자에서 Transurethial Radiofrequency Thermotherapy의 효과
Transurethral Radiofrequency Thermotherapy for Symptomatic Patients with Benign Prostatic Hyperplasia
전상현, 안동환, 정병하,
소속 상세정보
전상현 ( )
연세대학교 의과대학 비뇨기과학교실
안동환 ( )
연세대학교 의과대학 비뇨기과학교실
정병하 ( )
연세대학교 의과대학 비뇨기과학교실
KMID : 0358319980390111114
Abstract
서론
현재 경요도전립선절제술이 전립선비대증의 주된 수술적 치료임은 주지의 사실이나 술후
합병증이 있고, 입원 후 마취하에 시술을 해야한다는 단점이 있다. 이러한 단점을 극복하기
위해서 최근 전립선비대증의 여러 저침습적 치료법이 개발되었다. 그 중 고주파 에너지를
이용한 고온열치료(transuiethral radiofrequency thermotherapy; TURT)는 시술이 간편하고
안전하며 비용면에서 저렴하다는 장점이 있다. 그러나 치료효과면에서 만족할 만한 단기효
과가 있다는 보고가 있는 반면, 위약군과 비교할 때 별 차이가 없다는 보고가 있어, 아직까
지는 객관적인 호전의 여부 및 그 효과의 지속성에 대해서는 이론이 있다고 하겠다. 또한
사용하는 기종에 따라서 치료조건을 달리하기 때문에 일률적인 효과를 기대하기도 어려운
점이 있다. 본 교실에서는 도입 초기인 1994년 TURT의 단기 효과에 대해 보고한 바 있으
나, 이후에 이번 연구에서는 시행 후 2년까지의 장기 추적 결과를 알아보고자 하였다.
#초록#
Purpose: Recently, many alternative forms of non-surgical treatment modalities were
devised for the management of BPH and one of them is transurethral radiofrequency
thermotherapy(TURT). In this study, we investigated the long term efficacy of TURT.
Materials and Methods: A total of 132 patients with symptomatic BPH were treated in
a single session with TURT using Thermex-Ⅱ(47.5℃, 150minutes) and 88 patients who
were available to follow-up for more than 6 months after TURT were enrolled in this
study. Among them, 65 patients were available to follow-up for more than 2 years. The
baseline and post-treatment mean symptom score(Madson-Iversen), maximal flow
rate(MFR), residual urine volume and prostate volume were compared. Improvement was
defined as a reduction of more than 50% in at least one of two parameters(symptom
score and maximal flow rate). We also investigated whether other treatment modalities
were selected in 2 years after TURT.
Results: At 3 months follow-up, improvements were observed in 59.1%(52/88), and at 6
months 54.5%(48/88). However, improvements in both symptom score and maximal flow
rate at 3 and 6 months after treatment were only 27.3% and 20.5%, respectively. Among
65 patients who were available to follow-up for more than 2 years, 27 patients(41.5%)
had undergone transurethral resection of the prostate either with(19) or without
medication(8). 28 patients (43.1%) received medical therapy such as alpha blocker during
the last two years after TURT. The post-treatment values of the 10 patients who had
not received adjuvant therapy were not significantly different from those at baseline.
Conclusions: Although thermal treatment for BPH is an alternative option with minimal
complication in selected symptomatic patients who are not clear candidates for surgery
or high-risk patients, the long term effect of TURT is not sufficient to relieve the
obstructive and irritative symptoms of BPH.
키워드
Benign prostatic hyperplasia; Thermotherapy; Radiofrequency;
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