医学
剜除术
泌尿科
前列腺
国际前列腺症状评分
前列腺切除术
前列腺癌
根治性耻骨后前列腺切除术
尿失禁
尿失禁
下尿路症状
开放性前列腺切除术
膀胱出口梗阻
外科
癌症
内科学
作者
Nazareno Suardi,Vincenzo Scattoni,Alberto Briganti,Andrea Salonia,Richard Naspro,Andrea Gallina,Andrea Cestari,Renzo Colombo,Pierre I. Karakiewicz,Giorgio Guazzoni,Patrizio Rigatti,Francesco Montorsi
标识
DOI:10.1016/j.eururo.2007.07.027
摘要
To evaluate the feasibility and safety of nerve-sparing radical retropubic prostatectomy (NSRRP) for localised prostate cancer after holmium laser enucleation of the prostate (HoLEP) for bladder outlet obstruction due to benign prostatic enlargement (BPE).Fifteen consecutive patients with prostate cancer following HoLEP underwent NSRRP. They were matched with an equal number of patients who also underwent NSRRP following transurethral resection of the prostate (TURP group) or open prostatectomy (OP group). Patients were preoperatively assessed with validated questionnaires (International Prostate Symptom Score [IPSS] and International Index of Erectile Function-Erectile Function [IIEF-EF]). Intraoperative, perioperative, and follow-up functional data according to validated questionnaires (IPSS, IIEF-EF, International Consultation on Incontinence Questionnaire-Short Form [ICIQ-SF]) were evaluated with analysis of variance and chi2 tests.At diagnosis, the prostate-specific antigen (PSA) level, clinical stage, Gleason sum distributions, body mass index, ICIQ-SF, and IPSS were not significantly different among the groups. IIEF-EF scores was higher in the HoLEP group (p=0.02). Mean operative time was longer in the OP group (p=0.02), but no difference was found in mean blood loss (p=0.5). Final pathology showed no substantial differences among the groups, although a lower positive surgical margin rate was found in the HoLEP group (p=0.04). Mean follow-up was 23.8+/-10.5 mo. The groups showed no statistical differences in urinary continence rate (p=0.6), IPSS (p=0.3), or IIEF-EF (p=0.4).NSRRP is feasible in prostate cancer patients who previously underwent HoLEP for BPE and provides satisfactory functional outcomes.
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