BJU Int:核磁共振引导下的经尿道超声消融治疗前列腺增生

2021-07-09 AlexYang MedSci原创

许多男性因良性前列腺增生引起的前列腺梗阻(BPO)而患有LUTS。当保守治疗失败,需要手术治疗时,目前的金标准是TURP或内窥镜下的前列腺剜除术。

许多男性因良性前列腺增生引起的前列腺梗阻(BPO)而患有LUTS。当保守治疗失败,需要手术治疗时,目前的金标准是TURP或内窥镜下的前列腺剜除术。

近期,有研究调查了MRI引导下的经尿道超声消融术(TULSA)治疗良性前列腺梗阻(BPO)的安全性和可行性

该研究是一项由研究者发起的、前瞻性的、已注册的(NCT03350529)和一期的研究,招募了因BPH而需要手术干预的LUTS男性。患者在TULSA治疗后随访一年。在基线时和之后每三个月测定尿流率、PSA和进行全面的功能问卷调查,包括EPIC-26、IPSS和IIEF-5。在基线、TULSA术后3个月和12个月时进行MRI。记录了TULSA前后的用药情况,并使用Clavien-Dindo分类法报告不良事件。

结果发现,10名男性接受了TULSA治疗,没有发现严重的不良事件。基线中值(IQR)年龄和前列腺体积分别为68岁(63-72)和53毫升(45-66)。基线时,6名患者有中度症状,4名患者有严重的症状;有9名患者正在接受BPO药物治疗。IPSS的中位数(IQR)改善了82%,即从基线的17.5(15.3-23.0)到第12个月的4.0(2.3-6.3)。同样,中位数(IQR)Qmax改善了101%,从基线的12.4毫升/秒(8.8-17.6)到12个月时的21.8毫升/秒(17.6-26.5)。实际上,3个月时已经观察到了改善。12个月时,前列腺体积和PSA的中位数分别减少了33%和48%。在尿道、性功能、勃起功能或肠道功能方面没有观察到变化。在12个月时,在TULSA治疗前射精功能正常的6名男性中,有5名报告顺行射精功能正常。所有在TULSA之前服用BPO药物的患者在TULSA之后都停止了用药。

基线、3个月和12个月的测量结果

综上所述,TULSA似乎是一种安全有效的BPO治疗方法,其一年的随访结果令人鼓舞。但仍需进一步研究更大的队列来证实观察到的结果

原始出处:

Antti Viitala, Mikael Anttinen, Cameron Wright et al. MRI-guided transurethral ultrasound ablation for BPH: 12-month clinical outcomes of a phase I study. BJU Int. Jul 2021

 

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    2021-11-18 lifestar
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    2021-07-10 1211c54em14(暂无昵称)

    MRI引导下超声

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