2種の蒸散用電極を用いた前立腺肥大症に対する経尿道的前立腺電気蒸散術(TVP)の治療成績

Abstract

排尿障害を主訴とする109例に対して2種の蒸散用電極を用いた経尿道的前立腺電気蒸散術を施行した.TVPは従来のTUR-Pと同様の手技で施行することができ, 出血が少なく, 術後早期に症状の改善が認められた.TVPは前立腺肥大症に対する治療として極めて有用であり, その臨床効果もTUR-Pに匹敵する

Transurethral electrovaporization of the prostate (TVP) is a new minimally invasive procedure for treatment of enlargement of prostate. Between April 1996 and September 1997, TVP was carried out in 109 cases with symptoms of lower urinary tract obstruction. A Stortz spike electrode and a Stortz vapor cutting electrode were used for vaporization electrodes. Efficacy parameters evaluated included International Prostate Symptom Score, peak uroflow and postvoid residual volume. By September 1997, 32 cases (spike electrode) and 33 cases (vapor cutting electrode) could be followed up and evaluated. They have shown both subjective and objective voiding improvement. The improvements in subjective symptom scores and objective voiding parameters were not significantly different between the two electrode groups. Early complications included urinary retention, intraoperative burn, stress incontinence, blood transfusion and postoperative hemorrhage. Late complications included urethral stricture, bladder neck contracture and bladder stone. TVP was found to have several advantages, particularly minimal bleeding and the low incidence of postoperative morbidity. The technique is simple and symptoms improve at an early stage following surgery. This study demonstrates that TVP is a safe and effective modality for treatment of BPH. However, long-term studies with larger numbers of patients are needed.