个性化BPH管理:单独进行膀结石切除与同时进行激光核化-多中心视角与患者报告的结果和决策后悔分析
Ziv Savin1, Tomer Mendelson2, Linda Dayan Rahmani1
1Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, United States.
The Prostate
|March 6, 2026
概括
单独去除膀结石对于精选的良性前列腺增生症 (BPH) 患者来说是一个可行的选择. 对于BPH的手术治疗,应优先考虑阻塞的严重程度,而不是石头的存在,强调共享决策.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 手术创新 在外科创新.
- 以患者为中心的护理
背景情况:
- 结合膀结石去除与手术治疗良性前列腺增生 (BPH) 的必要性是有争议的.
- 这项研究比较了在BPH患者的膀结石移除的疗效和安全性,并没有同时进行外出手术.
研究的目的:
- 在BPH患者中,单独切除膀结石的结果与与前列腺的holmium激光除核 (HoLEP) 结合的结果进行比较.
- 评估并发症,石头复发,症状负担和长期满意度.
主要方法:
- 一项多中心雄心型队列研究包括BPH患者,膀结石大于1厘米.
- 与"HoLEP" (n=42) 组进行了比较",只有石头去除" (n=63) 组.
- 评估结果:90天的并发症,石头复发,IPSS分数和决策后悔.
主要成果:
- 与HoLEP相比,单独去除石头的复发率更高 (14%vs0%),但整体 (13%vs31%) 和主要并发症率较低 (0%vs5%).
- 尽管存在差异,77%的"仅去除石头"组在3年内仍然没有进行BPH手术,满意度更高.
- 开发了一个共享决策工具 (PreOp决策).
结论:
- 单独去除膀石块对于某些BPH患者来说是一个可行的选择.
- 对于BPH手术的决定,应以阻塞的严重程度为指导,而不仅仅是石头的存在.
- 共享决策,可能有验证问卷的帮助,对于治疗选择至关重要.
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