Urodynamic evaluation after high-intensity focused ultrasound for patients with prostate cancer.

IF 2.3 Q3 ONCOLOGY
Prostate Cancer Pub Date : 2014-01-01 Epub Date: 2014-05-15 DOI:10.1155/2014/462153
Luigi Mearini, Elisabetta Nunzi, Silvia Giovannozzi, Luca Lepri, Carolina Lolli, Antonella Giannantoni
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引用次数: 8

Abstract

This prospective study assesses the impact of high-intensity focused ultrasound (HIFU) on lower urinary tract by comparing pre- and postoperative symptoms and urodynamic changes. Thirty consecutive patients with clinically organ-confined prostate cancer underwent urodynamic study before HIFU and then at 3-6 months after surgery. Continence status and symptoms were analyzed by means of International Prostate Symptoms Score IPSS and International Index Erectile Function IIEF5. As a result, there were a significant improvement in bladder outlet, maximum flow at uroflowmetry, and reduction in postvoid residual PVR at 6-month follow-up and a concomitant significant reduction of detrusor pressure at opening and at maximum flow. De novo overactive bladder and impaired bladder compliance were detected in 10% of patients at 3 months, with progressive improvement at longer follow-up. Baseline prostate volume and length of the procedure were predictors of 6-month IPSS score and continence status. In conclusion, following HIFU detrusor overactivity, decreased bladder compliance and urge incontinence represent de novo dysfunction due to prostate and bladder neck injury during surgery. However, urodynamic study shows a progressive improvement in all storage and voiding patterns at 6-month follow-up. Patients with high prostate volume and long procedure length suffered from irritative symptoms even at long term.

Abstract Image

前列腺癌患者高强度聚焦超声后尿动力学评价。
本前瞻性研究通过比较术前和术后症状和尿动力学变化来评估高强度聚焦超声(HIFU)对下尿路的影响。连续30例临床器官局限性前列腺癌患者在HIFU前和术后3-6个月进行尿动力学研究。采用国际前列腺症状评分(IPSS)、国际勃起功能指数(IIEF5)对失禁状况和症状进行分析。结果,在6个月的随访中,膀胱出口、尿流测量的最大流量、膀胱后残留PVR的减少都有了显著的改善,同时在开口和最大流量时逼尿肌压力也有了显著的降低。10%的患者在3个月时发现膀胱过度活动和膀胱顺应性受损,在更长时间的随访中逐渐改善。基线前列腺体积和手术时间是6个月IPSS评分和尿失禁状态的预测因子。总之,HIFU逼尿肌过度活动后,膀胱依从性下降和急迫性尿失禁代表手术中前列腺和膀胱颈损伤所致的新生功能障碍。然而,尿动力学研究显示,在6个月的随访中,所有的储存和排尿模式都有所改善。前列腺体积大、手术时间长的患者即使长期存在刺激性症状。
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来源期刊
Prostate Cancer
Prostate Cancer ONCOLOGY-
CiteScore
2.70
自引率
0.00%
发文量
9
审稿时长
13 weeks
期刊介绍: Prostate Cancer is a peer-reviewed, Open Access journal that provides a multidisciplinary platform for scientists, surgeons, oncologists and clinicians working on prostate cancer. The journal publishes original research articles, review articles, and clinical studies related to the diagnosis, surgery, radiotherapy, drug discovery and medical management of the disease.
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