Transurethral resection of benign prostatic hyperplasia using a vaporizing resecting loop, UROloop

Abstract

対象は1996年4月より1997年3月迄の間, 筑波学園病院においてUROloopを用いてTUR-Pを施行した24症例.各々の症例でIPSS, 最大尿流量(PFR), 残尿量(PVR)を治療効果指標として, 又手術前後の血中ヘモグロビン値とナトリウム値も安全指標として比較検討した.IPSSの平均値は術前値15.4±1.4から術後12週で4.3±0.27へ有意(p=0.0002)に低下し, PFRも術前12.1±0.8ml/sから術後26.2±1.85ml/sへ(p=0.002), PVRも術前65.4±21.1mlから術後15.2±7.8mlへ(p=0.033)と各々に有意に改善した.一方で重篤な合併症は認められず, 術前後の血清ナトリウムとヘモグロビン値の変化は僅かであった

New electrosurgical instruments for the treatment of benign prostatic hyperplasia (BPH) have been developed during the past few years. We determined the efficacy and safety of transurethral prostatectomy (TUR-P) using a new electrosurgical device (UROloop) for the treatment of BPH. Twenty-four patients, with a mean age of 67.7 years, with BPH underwent TUR-P using the UROloop between April 1996 and March 1997. We evaluated the pre- and postoperative symptom scores and urodynamic parameters of the patients. The International Prostate Symptom Score (IPSS) was used for symptom scoring. The urodynamic parameters included peakflow rates (PFR) and postvoid residual urine (PVR). The average preoperative IPSS score for all patients was 15.4 +/- 1.4. The IPSS score was significantly improved to 4.3 +/- 0.24 at 12 weeks after the TUR-P (p = 0.0002). The average PFR was increased by 117% at 12 weeks postoperatively. The average preoperative PVR of 65.4 ml was reduced to 15.2 ml postoperatively. The changes in the urodynamic parameters were statistically significant. No severe complications were observed in the present study. The changes in the serum sodium and hemoglobin levels were small. This study revealed significantly sustained clinical improvement with minimal morbidity. The results of the present study also confirmed the usefulness of the new endoscopic treatment for BPH.