Effect of Photoselective Vaporization Prostatectomy on Lower Urinary Tract Symptoms in Benign Prostatic Hyperplasia With or Without Intravesical Prostatic Protrusion
김명수, 정병하, 이승환, 박경기,
소속 상세정보
김명수 ( Kim Myung-Soo )
Uological Science Institute Gangnam Severance Hospital Department of Urology
정병하 ( Chung Byung-Ha )
Uological Science Institute Gangnam Severance Hospital Department of Urology
이승환 ( Lee Seung-Hwan )
Uological Science Institute Gangnam Severance Hospital Department of Urology
박경기 ( Park Kyung-Kgi )
Uological Science Institute Yongin Severance Hospital Department of Urology
KMID : 0358320130540010036
Abstract
Purpose: Intravesical protrusion of the prostate (IPP) can affect voiding. We evaluated the improvement in lower urinary tract symptoms and patient satisfaction after laser prostate photovaporization in benign prostatic hyperplasia (BPH) patients with or without IPP.
Materials and Methods: This prospective study included 134 patients who underwent GreenLight HPS laser photoselective vaporization prostatectomy (PVP) between January 2010 and July 2011 patient. Preoperative IPP was evaluated by using the retroflexed view from flexible cystoscopy. evaluation included complete medical history, International Prostate Symptom Scores (IPSS), maximum flow rate (Qmax), postvoid residual (PVR), serum prostate-specific antigen (PSA), and transrectal ultrasonogram. Changes from baseline in Qmax, PVR, total IPSS, and IPSS subscores (voiding and storage) were analyzed at postoperative months 1, 3, and 6.
Results: The patients’ mean age was 66.6±7.8 years. Mean serum PSA and prostate volume were 1.7±1.5 ng/mL and 42.9±16.7 g, respectively. No significant differences existed between the IPP and no IPP groups in preoperative prostate volume, total IPSS, PSA, or lasing time and energy. The mean follow-up duration was 6.2±1.9 months. IPP patients showed significant improvements in total IPSS and voiding subscores at months 1 and 3. Improvements in the quality of life score and storage subscore were not significantly different between the groups. Qmax was significantly improved at 6 months postoperatively in the IPP group versus the no IPP group.
Conclusions: Among patients who underwent PVP for BPH, the IPP group showed more symptom improvement, especially in voiding symptoms, than did the no IPP group. Preoperative cystoscopy is helpful for evaluating IPP and for anticipating postoperative outcome.
키워드
Lasers;Prostate;Prostatic hyperplasia;Transurethral resection of prostate;Urinary bladder neck obstruction
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