前立腺肥大症に対する半導体レーザーを用いたInterstitial laser coagulation of the prostate(ILCP)の治療成績

Abstract

1)対象20例における自覚症状の改善は1ヵ月後は約7割, 3ヵ月後に約9割にみられ, その後はほぼ変化はなかった. 2)前立腺体積は1ヵ月後から減少し6ヵ月後まで減少傾向を示した.Qmaxも3ヵ月後に半数が改善し6ヵ月後まで改善傾向を示した. 3)全般的な有効性は1ヵ月後, 3ヵ月後, 6ヵ月後で各々62.5%, 85.0%, 100%であった. 4)ILCPは前立腺肥大症に対する治療の選択肢の1つとして有力と考えた

Interstitial laser coagulation (ILCP) is currently considered to be one of the avenues for treatment of benign prostatic hyperplasia (BPH). The efficacy and effectiveness of the treatment, however, have not been well clarified. Here we report the outcome of treatment in benign prostatic hyperplasia using ILCP. Twenty patients with BPH who underwent interstitial laser coagulation using a diode laser between March and December 1998 were investigated. Our results showed that there are significant improvements in prostate symptom score and quality of life index after the treatment. According to the efficacy criteria, 70% of the patients showed clinical improvement of both scores at 1 month, and more than 90% of the patients at 3 months. The reduction of prostate volume was observed after 1 month of treatment and continued for 6 months. The improvement on peak flow rate was observed in 50% of the patients at 3 months and in 73.3% of the patients at 6 months. The overall efficacy rates were 62.5%, 85.0% and 100% of the patients at 1, 3 and 6 months, respectively. In all 20 patients the complications were minimal. No blood transfusion was required in any patients. However, one patient experienced both epididymitis and prostatic abscess and was treated with conservative therapy. In conclusion, interstitial laser coagulation using a diode laser is a very effective means for the treatment of benign prostatic hyperplasia. Because of its less invasive nature, we strongly recommend that ILCP be the major way of treatment for benign prostatic hyperplasia.