Περίληψη:
Purpose: To evaluate the effectiveness of the ProstaLund (R) Compact
Device in the treatment of benign prostatic hyperplasia (BPH).
Patients and Methods: A series of 38 consecutive patients with a mean
age of 72.6 +/- 8.2 years, 19 with an indwelling catheter, underwent
transurethral microwave thermotherapy (TUMT) with the ProstaLund Compact
Device. Pretreatment evaluation included transrectal ultrasonography
(TRUS), urodynamics, and cystoscopy for all patients and flow rate
(Q(max)), postvoiding residual urine volume (PVR), International
Prostate Symptom Score (IPSS), and quality-of-life (QoL) assessment for
those without a catheter. The mean prostate volume was 63.5 +/- 30 cc.
The Q(max), IPSS, and QoL studies were repeated at 3, 6, and 12 months,
while urodynamics, cystoscopy, and TRUS were repeated at 6 and 12
months.
Results: The treatment lasted a mean of 43.1 +/- 17.1 minutes, achieved
a maximal intraprostatic temperature of 58.7 +/- 7.2 degrees C, and
destroyed 18.4 +/- 14.3 g of prostatic tissue. Twelve months
post-treatment, for the patients without a catheter preoperatively, the
IPSS was improved from 21.5 +/- 6.3 to 6.5 +/- 3.1 (P < 0.001), Q(max)
from 7.2 +/- 3.1 mL/sec to 18.1 +/- 7.4 mL/sec (P < 0.001), detrusor
pressure at Q(max) from 87.5 +/- 15 cm H2O to 48.4 +/- 16.4 cm H2O (P <
0.001), and PVR from 113.2 +/- 78.2 mL to 34.6 +/- 36.7 mL (P < 0.01).
The good-response rates for IPSS (<= 7 or >= 50% improvement), Q(max)
(>= 15 mL/sec or >= 50% improvement), PVR (< 50 mL or >= 50%
decrease), and QoL (:52) were 73.7%, 84.2%, 73.7%, and 94.7%,
respectively. For the patients with a catheter preoperatively, the IPSS
improved from 9.5 +/- 6 at 3 months to 5.1 +/- 5.3 (P < 0.05) at the end
of the follow-up period. The Q(max) was 13.2 +/- 6.4 mL/sec at 3 months
and remained stable throughout the follow-up period. Patient
good-response rates for IPSS (:57), PVR (< 150 mL), and QoL (:52) were
75%, 87.5% and 75%, respectively. Only two patients were unable to
void after the treatment. Complications were similar to those presented
in the literature, and bladder stone formation was noted as well (five
patients).
Conclusions: ProstaLund thermotherapy is a highly promising alternative
treatment for BPH, improving substantially both objective and subjective
measures of bladder outflow obstruction.
Συγγραφείς:
Alivizatos, G
Ferakis, N
Mitropoulos, D
Skolarikos, A and
Livadas, K
Kastriotis, I
