HoLEP術後1年目までの尿失禁・性機能の推移

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We performed holmium laser enucleation of the prostate (HoLEP) on 98 patients between February 2005 and February 2007. Seventy five patients with the mean age of 68.9 (ranging 55-84) were assessed preoperatively and followed up at 1, 3 and 12 months postoperatively. Before and after HoLEP, International Prostate Symptom Score (IPSS), quality of life (QOL) index, maximum flow rate (Qmax) and post-void residual (PVR) urine were all improved significantly (P or = 1, incontinence was observed in 71% of patients preoperatively. ICIQ-SF scores were increased from 5.2 preoperatively to 8.0 at 1 month postoperatively, but improved thereafter and had decreased significantly to 2.5 (p < 0.05 compared with baseline) at 12 months. Univariate and multivariate logistic regression analysis revealed date of operation and operation time were significantly (P < 0.05) correlated with postoperative stress urinary incontinence (SUI) at 1 month and enucleated volume was of borderline significance (p = 0.052) at 12 months. In terms of sexual function, mean IIEF5 scores were not significantly changed, but we could classify the scores into five types of response-unchanging (64%), improving (13%), worsening (11%), transient worsening (9%) and unclassified (2%). HoLEP is an effective treatment for BPH. Urinary incontinence improved by 1 year. HoLEP does not appear to affect sexual function, but various clinical courses were observed.
泌尿器科紀要刊行会の論文