超声引导下经会阴激光消融治疗良性前列腺增生（附2例报告）

目的探讨超声引导下经会阴激光消融治疗良性前列腺增生（BPH）的安全性、可行性及其临床价值，探索BPH治疗的新方法。 方法对药物治疗失效、不耐受常规手术的2例重度良性前列腺增生患者行经会阴激光消融治疗，术后超声造影评估消融范围，观察并发症发生等情况。术后1个月、2个月密切随访，进行疗效评估，并行影像学检查。 结果2例患者术后即刻超声造影证实前列腺左、右侧内腺消融区较精确地符合术前手术方案，未发生明显并发症。术后2个月随访，2例患者下尿路症状均明显改善，国际前列腺症状评分（IPSS）分别由术前35分、32分降至术后5分、6分。前列腺体积分别由术前的62.7 ml、84.3 ml减小至术后61.2 ml、84.1 ml。 结论经会阴BPH激光消融是一项安全、精准、最为微创的新方法，短期疗效显著，可为临床药物治疗失效、不耐受常规手术等困难BPH患者的治疗提供一种新思路。

Ultrasound-guided transperineal laser ablation on benign prostatic hyperplasia: 2 cases report

ObjectiveTo investigate the safety, feasibility and clinical value of the ultrasound-guided transperineal laser ablation (TPLA) for benign prostatic hyperplasia (BPH) and to explore a new method for BPH treatment. MethodsTwo patients with severe benign prostatic hyperplasia, who had experienced drug treatment failure and had intolerance to conventional surgery, were treated by TPLA. The postoperative range of ablation was evaluated by contrast-enhanced ultrasound and complications were observed. The patients were closely followed up in one and two months after operation. The curative effect was evaluated and the imaging examination was performed. ResultsThe immediate contrast-enhanced ultrasound of the two patients confirmed that the ablation area of both left and right inner gland were in accordance with the preoperative surgical plan and no obvious complications were observed. The follow-ups after the operation suggested that the lower urinary tract symptoms of the two patients were significantly improved. The International Prostate Symptom Score (IPSS) decreased from 35 points and 32 points to 5 points and 6 points, respectively. The preoperative prostatic volumes were 62.7 ml and 84.3 ml, while the postoperative volumes were 61.2 ml and 84.1 ml, respectively. ConclusionTPLA is a safe, accurate and minimally invasive method with significant short-term curative effect, which can provide a new idea for the treatment of BPH with clinical drug treatment failure and non-tolerance to conventional surgery.