The Impact of Increased Bladder Blood Flow on Storage Symptoms after Holmium Laser Enucleation of the Prostate

被引:6
|
作者
Saito, Keisuke [2 ]
Hisasue, Shin-ichi [1 ]
Ide, Hisamitsu [2 ]
Aoki, Hiroaki [1 ]
Muto, Satoru [2 ]
Yamaguchi, Raizo [2 ]
Tsujimura, Akira [1 ]
Horie, Shigeo [1 ]
机构
[1] Juntendo Univ, Grad Sch Med, Dept Urol, Bunkyo Ku, Tokyo 1130033, Japan
[2] Teikyo Univ, Sch Med, Dept Urol, Itabashi Ku, Tokyo 1738605, Japan
来源
PLOS ONE | 2015年 / 10卷 / 06期
关键词
URINARY-TRACT SYMPTOMS; MEN;
D O I
10.1371/journal.pone.0129111
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
In order to investigate how holmium laser enucleation of the prostate (HoLEP) improves urinary storage symptoms, we assessed blood flow in the urinary bladder mucosa of patients with benign prostatic hyperplasia (BPH) before and after laser surgery. Seventy-four consecutive patients with BPH (median age 69 years, range; 53-88) underwent HoLEP at our institution and are included in this study. We prospectively assessed the International Prostate Symptom Score (IPSS), IPSS-QOL Score, the Overactive Bladder Symptom Score (OABSS), uroflowmetry, and blood flow in the urinary bladder, before and after surgery. Blood flow in the bladder mucosa was measured using the OMEGA FLOW (OMEGA-WAVE, Tokyo, Japan) laser Doppler flowmeter. The median volume of the enucleated adenomas was 45.0 g (range: 25.0 to 83.2). The median IPSS improved significantly from 20 (range: 6-35) to 3 (0-22) (p<0.001; Wilcoxon signed-rank test), as did the storage symptoms score, which decreased from 13 (2-20) to 3 (1-8) (p<0.001). Median bladder blood flow increased at the trigone from 9.57 +/- 0.83 ml/sec to 17.60 +/- 1.08 ml/sec. Multiple regression analysis for the improved storage symptom score eliminated all explanatory variables except increased bladder perfusion. The data suggest that HoLEP improves blood flow in the bladder mucosa, which independently leads to the improvement of storage symptoms.
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页数:8
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