전립선비대증의 간질성 레이저응고술 후 치료 효과에 관한 만족도 분석

초록

Purpose: We underwent prospective studies on the patient`s satisfaction after interstitial laser coagulation (ILC) of the prostate for treating BPH through the analysis of clinical and urodynamic investigations. Materials and Methods: 32 patients with BPH were treated by ILC using Indigo diode laser between November 1996 and December 1998. Patients had undergone preoperatively clinical [international prostate symptom score (IPSS), uroflowmetry, prostatic volume measurement] and urodynamic study. Same studies were repeated postoperatively at 6th and 12th month. Postoperative patient`s satisfaction was determined by subjective responses to the questionnaires and each response was categorized into one of the two results groups; good(much improved, improved) and poor(slightly improved, no change, getting worse). The patient`s satisfaction, and clinical and urodynamic parameters were compared and analyzed.Results: Of the total, 18 patients (56.3%) had bladder outlet obstruction (BOO; defined as linearized passive urethral resistance relation (L-PURR)≥3), while 17 patients (53.1%) demonstrated associated detrusor instability (DI). Significant improvements in IPSS, quality of life (QOL), peak flow rate, postvoid residual and reduction of prostate volume were noted in all patients postoperatively. Postoperative patient`s satisfactions were significantly greater in the patients with BOO (61.1%) than those without BOO (35.0%). 83.3% of the patients who showed only DI preoperatively showed poor patient`s satisfaction. Preoperative work factor (WFmax) was significantly greater in the patients with good results than those without. Conclusions: After ILC, there were no significant differences in the improvements of clinical parameters between BOO and those without. However, postoperative patient`s satisfaction was greater in patients with BOO. Also, the preoperative detrusor contractility positively affected patient`s satisfaction to the treatment. To enhance the postoperative patient`s satisfaction, urodynamic study for selection of proper patient group will be indicated.

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