年轻男性经尿道前列腺切除术:疗效和长期结果。

IF 1.4 Q2 MEDICINE, GENERAL & INTERNAL
Kamil Malshy, Etan Eigner, Anna Ochsner, John Morgan, Ameer Nsair, Borivoj Golijanin, Michael Mullerad
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引用次数: 0

摘要

研究目的本研究旨在调查年轻男性患者经尿道前列腺切除术(TURP)的疗效和结果:方法:对 2011 年 1 月至 2023 年 8 月期间在兰巴姆医疗保健园区接受经尿道前列腺电切术的 55 岁以下男性患者进行回顾性研究。收集了临床人口学特征、手术适应症、尿流测定、压力-流量研究以及术后早期和晚期结果。排除了尿道或膀胱异常的患者。采用卡方检验和费雪精确检验进行双变量分析:符合纳入标准的 58 名男性接受了前列腺电切术,他们的中位年龄为 52 岁(四分位距[IQR] 49.5-54)。前列腺大小中位数为 35 毫升(24.5-56),前列腺特异性抗原中位数为 1.4 纳克/毫升(0.65-3.1)。共有60%的患者在手术前使用了α受体阻滞剂,19%的患者使用了5α还原酶抑制剂。总体而言,54 例(93.1%)患者有严重的下尿路症状(LUTS),其中 34 例(59%)以排空症状为主,20 例(35%)以储尿症状为主。大多数手术是针对难治性下尿路症状(LUTS)进行的,38 例(66%),其次是尿潴留,16 例(28%)。6 周后,57 名(98%)患者不再使用导尿管。最大尿流率和残余尿量均有显著改善,从中位数 6.85 毫升/秒提高到 17.9 毫升/秒(PConclusions.TURP):在年轻男性中,TURP 可在短期内提高血流测量和导管移除率,但从长远来看,仍需进行后续手术。在这一特殊人群中,应谨慎选择患者,并考虑采取其他侵袭性较小的干预措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Transurethral Resection of the Prostate in Younger Men: Effectiveness and Long-term Outcomes.

Objectives: This study aims to investigate the efficacy and outcomes of transurethral resection of the prostate (TURP) in the context of younger male patients.

Methods: Males aged ≤55 who underwent TURP at Rambam Health Care Campus from January 2011 to August 2023 were retrospectively reviewed. Clinicodemographic characteristics, indications for surgery, uroflowmetry, pressure-flow study, and early and late postoperative outcomes were collected. Patients with urethral or bladder abnormalities were excluded. Chi-square and Fisher's exact tests were employed for bivariate analysis.

Results: Inclusion criteria were met by 58 men who underwent TURP at a median age of 52 years (interquartile range [IQR] 49.5-54). Median prostate size was 35 mL (24.5-56), with median prostate-specific antigen of 1.4 ng/mL (0.65-3.1). A total of 60% of patients used α-blockers, and 19% used 5α-reductase inhibitors pre-surgery. Overall, 54 (93.1%) had severe lower urinary tract symptoms (LUTS), with 34 (59%) being predominantly emptying and 20 (35%) storage. Most surgeries were performed for refractory LUTS in 38 (66%), followed by urinary retention in 16 (28%). At 6 weeks, 57 (98%) patients were catheter-free. The maximum flow rate and residual volume showed significant improvement from a median of 6.85 mL/s to 17.9 mL/s (P<0.001), and from 120 mL to 10 mL (P=0.0142), respectively. Pathology revealed benign prostatic hyperplasia in 53 (91.4%), and inflammation in 5 (8.5%). A total of 13 auxiliary procedures were required in 12 patients (20.7%) during follow-up: 7 transurethral bladder neck incisions, 3 re-TURP, 1 meatus widening, and 1 patient required artificial urinary sphincter implantation followed by simple cystectomy for end-stage bladder.

Conclusions: In young men, TURP showed short-term gains in flowmetry and catheter removal rates, but a sustained need for subsequent procedures in the long run. In this unique population, patients should be carefully selected, and alternative, less aggressive, interventions should be considered.

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来源期刊
Rambam Maimonides Medical Journal
Rambam Maimonides Medical Journal MEDICINE, GENERAL & INTERNAL-
CiteScore
3.20
自引率
6.70%
发文量
55
审稿时长
8 weeks
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