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전립선비대증에서 KTP 레이저를 이용한 광선택적 전립선 기화술의 치료효과 및 안전성에 대한 결과: 2년 추적관찰

The Efficacy and Safety of KTP Photoselective Vaporization of the Prostate for the Treatment of Benign Prostatic Hyperplasia: The 2-year Results

대한비뇨기과학회지 2008년 49권 9호 p.831 ~ 836
추설호 ( Choo Seol-Ho ) - 성균관대학교 의과대학 비뇨기과학교실

한덕현 ( Han Deok-Hyun ) - 성균관대학교 의과대학 비뇨기과학교실
이성원 ( Lee Sung-Won ) - 성균관대학교 의과대학 비뇨기과학교실

Abstract


Purpose: This study was conducted to evaluate, with using the 2-year follow-up data, the clinical efficacy and safety of performing photoselective vaporization of the prostate(PVP) for the treatment of symptomatic benign prostatic hyperplasia(BPH).

Materials and Methods: We analyzed the clinical data of 104 men with symptomatic BPH and who had undergone PVP. The efficacy parameters were the changes from baseline of the International Prostate Symptom Score(IPSS), the quality of life(QoL) score, the maximum urinary flow rate(Qmax) and the postvoid residual volume(PVR). The patients were evaluated preoperatively and then at post-operative 1, 3, 6, 12 and 24 months. Their complications were also evaluated.

Results: The mean prostate volume was 45.6ml. The mean lasing time was 44.9 minutes and there was no significant blood loss or fluid absorption during or immediately after PVP. Significant improvements in the IPSS, the QoL score, the Qmax and the PVR were noted as early as 1 month after PVP treatment. After 24-month follow-up, the mean IPSS decreased from 22.4 to 9.9(p<0.0001) and the QoL score decreased from 4.4 to 2.3 (p<0.0001), while the mean Qmax changed from 8.3 to 14.4ml/sec(p< 0.0001). The PVR decreased from 82.0 to 49.9ml(p=0.033). The complications were retrograde ejaculation(26.9%), transient catheterization(6.7%), transient dysuria(2.9%), bladder neck contracture(1.9%), urethral stricture (0.9%) and meatal stenosis(0.9%). 1 patient was diagnosed with prostate cancer 32 months after operation.

Conclusions: Significant improvements of the subjective and objective voiding parameters were achieved and these were sustainable for at least 2-year, with minimal complications, after PVP. PVP seems to be a safe and effective treatment for symptomatic BPH.

키워드

Prostatic hyperplasia;Laser therapy;Treatment outcome
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