摘要
No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Jun 2004TRANSURETHRAL NEEDLE ABLATION VERSUS TRANSURETHRAL RESECTION OF THE PROSTATE FOR THE TREATMENT OF SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA: 5-YEAR RESULTS OF A PROSPECTIVE, RANDOMIZED, MULTICENTER CLINICAL TRIAL BRIAN HILL, WILLIAM BELVILLE, REGINALD BRUSKEWITZ, MUTA ISSA, RAMON PEREZ-MARRERO, CLAUS ROEHRBORN, MARTHA TERRIS, and MICHAEL NASLUND BRIAN HILLBRIAN HILL , WILLIAM BELVILLEWILLIAM BELVILLE , REGINALD BRUSKEWITZREGINALD BRUSKEWITZ , MUTA ISSAMUTA ISSA , RAMON PEREZ-MARRERORAMON PEREZ-MARRERO , CLAUS ROEHRBORNCLAUS ROEHRBORN , MARTHA TERRISMARTHA TERRIS , and MICHAEL NASLUNDMICHAEL NASLUND View All Author Informationhttps://doi.org/10.1097/01.ju.0000127761.87421.a0AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We report the 5-year efficacy and safety of transurethral needle ablation of the prostate (TUNA) compared to transurethral resection of the prostate (TURP) for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). Materials and Methods: A total of 121 men 50 years or older with LUTS secondary to BPH a minimum of 3 months in duration were enrolled in this prospective, randomized clinical trial at 7 medical centers across the United States. Of the participants 65 (54%) were randomly selected to receive TUNA and 56 (46%) were selected to receive TURP. International Prostate Symptom Score, quality of life, peak urinary flow rate, post-void residual urinary volume, and prostate size and configuration were evaluated before the procedure and then annually for 5 years after the procedure. Adverse events were also recorded throughout the study. Results: Improvement from baseline for TUNA and TURP retained statistical significance at each interval for International Prostate Symptom Score, quality of life and peak flow rate. Post-void residual volume was statistically significant at all time points for TURP and at year 5 for TUNA. The TURP group reported 41% retrograde ejaculation, while the TUNA group reported none. The incident of erectile dysfunction, incontinence and stricture formation was also greater in TURP than in TUNA cases with significantly fewer adverse events for TUNA than for TURP. Conclusions: The results of this study demonstrate stable treatment outcomes after 5 years of followup and suggest that TUNA is an attractive treatment option for men with LUTS due to BPH. References 1 : The prevalence of prostatism: a population-based survey of urinary symptoms. J Urol1993; 150: 85. Link, Google Scholar 2 : Finasteride significantly reduces acute urinary retention and need for surgery in patients with symptomatic benign prostatic hyperplasia. Urology1997; 49: 839. Google Scholar 3 : Prospective study of men with clinical benign prostate hyperplasia treated with alfuzosin by general practitioners: 1-year results. Urology1996; 48: 731. 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Link, Google Scholar From the Division of Urology, University of Maryland School of Medicine, Baltimore, Maryland, Department of Urology, University of Michigan School of Medicine, Ann Arbor, Michigan, Center for Health Sciences, University of Wisconsin Hospital and Clinics, Madison, Wisconsin, Department of Urology, Emory University School of Medicine, Atlanta, Georgia, Urology Health Center, New Port Richey, Florida, Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, and Department of Urology Stanford and Palo Alto Veterans Affairs Medical Center, Palo Alto, California© 2004 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byMcVary K, Gittelman M, Goldberg K, Patel K, Shore N, Levin R, Pliskin M, Beahrs J, Prall D, Kaminetsky J, Cowan B, Cantrill C, Mynderse L, Ulchaker J, Tadros N, Gange S and Roehrborn C (2021) Final 5-Year Outcomes of the Multicenter Randomized Sham-Controlled Trial of a Water Vapor Thermal Therapy for Treatment of Moderate to Severe Lower Urinary Tract Symptoms Secondary to Benign Prostatic HyperplasiaJournal of Urology, VOL. 206, NO. 3, (715-724), Online publication date: 1-Sep-2021.Rosario D, Phillips J and Chapple C (2018) Durability and Cost-Effectiveness of Transurethral Needle Ablation of the Prostate as an Alternative to Transurethral Resection of the Prostate When α-Adrenergic Antagonist Therapy FailsJournal of Urology, VOL. 177, NO. 3, (1047-1051), Online publication date: 1-Mar-2007.NASLUND M, CARLSON A and WILLIAMS M (2018) A COST COMPARISON OF MEDICAL MANAGEMENT AND TRANSURETHRAL NEEDLE ABLATION FOR TREATMENT OF BENIGN PROSTATIC HYPERPLASIA DURING A 5-YEAR PERIODJournal of Urology, VOL. 173, NO. 6, (2090-2093), Online publication date: 1-Jun-2005. Volume 171Issue 6 Part 1June 2004Page: 2336-2340 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.Keywordsurinary tractprostatic hyperplasiaprostatetransurethral resection of prostateMetricsAuthor Information BRIAN HILL More articles by this author WILLIAM BELVILLE More articles by this author REGINALD BRUSKEWITZ More articles by this author MUTA ISSA More articles by this author RAMON PEREZ-MARRERO More articles by this author CLAUS ROEHRBORN More articles by this author MARTHA TERRIS More articles by this author MICHAEL NASLUND Financial interest and/or other relationship with Glaxo, Merck, Medtronic and Celsion. More articles by this author Expand All Advertisement PDF downloadLoading ...