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首页> 外文期刊>BJU international >A randomized trial comparing bipolar transurethral vaporization of the prostate with GreenLight laser?(xps‐180watt) photoselective vaporization of the prostate for treatment of small to moderate benign prostatic obstruction: outcomes after 2 years
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A randomized trial comparing bipolar transurethral vaporization of the prostate with GreenLight laser?(xps‐180watt) photoselective vaporization of the prostate for treatment of small to moderate benign prostatic obstruction: outcomes after 2 years

机译：随机试验比较前列腺激光器的前列腺血管蒸发（XPS-180WATT）前列腺的光电蒸发，治疗小于中度良性前列腺梗阻：2年后的结果

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Objective To test the non‐inferiority of bipolar transurethral vaporization of the prostate (TUVP) compared to GreenLight laser (GL) photoselective vaporization of the prostate (PVP) for reduction of benign prostatic hyperplasia‐related lower urinary tract symptoms in a randomized trial. Methods Eligible patients with prostate volumes of 30–80?mL were randomly allocated to GL‐PVP ( n = 58) or bipolar TUVP ( n = 61). Non‐inferiority of symptom score (International Prostate Symptom Score [IPSS]) at 24?months was evaluated. All peri‐operative variables were recorded and compared. Urinary (IPSS, maximum urinary flow rate and post‐void residual urine volume) and sexual (International Index of Erectile Function‐15) outcome measures were evaluated at 1, 4, 12 and 24?months. Need for retreatment and complications, change in PSA level and health resources‐related costs of both procedures were recorded and compared. Results Baseline and peri‐operative variables were similar in the two groups. At 1, 4, 12 and 24?months, 117, 116, 99 and 96 patients, respectively, were evaluable. Regarding urinary outcome measures, there was no significant difference between the groups. The mean ± sd IPSS at 1 and 2?years was 7.1 ± 3 and 7.9 ± 2.9 ( P ?=?0.8), respectively, after GL‐PVP and 6.3 ± 3.1 and 7.2 ± 2.8, respectively, after bipolar TUVP ( P ?=?0.31). At 24?months, the mean difference in IPSS was 0.7 (95% confidence interval ?0.6 to 2.3; P ?=?0.6). The median (range) postoperative PSA reduction was 64.7 (25–99)% and 65.9 (50–99)% ( P ?=?0.006) after GL‐PVP, and 32.1 (28.6–89.7)% and 39.3 (68.8–90.5)% ( P ?=?0.005) after bipolar TUVP, at 1 and 2?years, respectively. After 2?years, retreatment for recurrent bladder outlet obstruction was reported in eight (13.8%) and 10 (16.4%) patients in the GL‐PVP and bipolar TUVP groups, respectively ( P ?=?0.8). The mean estimated cost per bipolar TUVP procedure was significantly lower than per GL‐PVP procedure after 24?months ( P ?=?0.01). Conclusions In terms of symptom control, bipolar TUVP was not inferior to GL‐PVP at 2?years. Durability of the outcome needs to be tracked. The greater cost of GL‐PVP compared with bipolar TUVP is an important concern.
机译：目的测试前列腺激光（GL）前列腺激光（GL）光电子蒸发的前列腺（TUVP）对前列腺激光（PVP）的非劣升性，以减少随机试验中的良性前列腺增生相关的尿路症状。方法将符合条件的前列腺量为30-80？ml的患者随机分配给GL-PVP（n = 58）或双极TUVP（n = 61）。症状评分的不较低（国际前列腺症状评分[IPSS]）在24个月内进行评估。所有PERI操作变量都被记录并进行了比较。尿（IPS，最大尿流率和禁止后尿液尿卷）和性（国际勃起函数-15的国际指数）在1,4,12和24个月内评估结果措施。需要恢复和并发症，记录和比较两种程序的PSA水平和健康资源相关成本的变化。结果在两组中，基线和Peri操作变量相似。在1,4,12和24岁以下，分别是评价117,116,99和96名患者。关于泌尿情况措施，组之间没有显着差异。 1和2的平均值±SD IPSS分别为7.1±3和7.9±2.9（P？= 0.8），分别在BIPOLAR TUVP之后分别在BL-PVP和6.3±3.1和7.2±2.8之后（P？ =？0.31）。在24个月中，IPS的平均差异为0.7（95％置信区间？0.6至2.3; p？= 0.6）。在GL-PVP后，术后PSA术后PSA减少为64.7（25-99）％和65.9（50-99）％（p？= 0.006），32.1（28.6-89.7）％和39.3（68.8-90.5双极Tuvp后的％（p？= 0.005），分别为1和2年。 2年后，PL-PVP和双极Tuvp组中的八（13.8％）和10名（16.4％）患者分别报告了复发性膀胱出口梗阻的后退（P？= 0.8）。每双极Tuvp程序的平均估计成本明显低于24个月后的GL-PVP程序（p？= 0.01）。在症状控制方面结论，双极Tuvp在2年的GL-PVP不逊色。需要跟踪结果的耐久性。与双极TUVP相比，GL-PVP的成本越大是一个重要问题。

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