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| 發表人 | 討論主題 | 發表時間 | 討論數 |
| 莊燿吉 | 良性攝護腺肥大伴隨難治的尿滯留又不適合手術的患者在攝護腺內注射A型肉毒桿菌素，攝護腺體積與排尿改善的效果 | 2007/12/19 下午 06:38:46 | 0 |
| 原 文 | 題 目 | Intraprostatic botulinum toxin type a injection in patients unfit for surgery presenting with refractory urinary retention and benign prostatic enlargement. Effect on prostate volume and micturition resumption. |
| 作 者 | Silva J, Silva C, Saraiva L, Silva A, Pinto R, Dinis P, Cruz F. | |
| 出 處 | European urology | |
| 出版日期 | Jan;53(1):153-9 | |
| 評 論 |
作者研究於良性攝護腺肥大患者接受攝護腺內注射A型肉毒桿菌素，對 於攝護腺體積與排尿改善的效果。 二十一位平均年齡為80歲，.患有良性攝護腺肥大與尿滯留超過三個月以上但未接受過手術治療的男性，在超音波的輔助之下，在未麻醉的情況下於攝護腺移形區注射200單位的A型肉毒桿菌素。患者在基準點的平均攝護腺體積為70毫升，1個月後降到57 (p<0.0006) ； 在3個月降到47毫升(p=0.03 與1個月比)。 在1個月後，有16位病人(76%) 可恢復解尿，其平均最大尿流速為9.0毫升/秒。 在3個月後，17位病人(81%)的平均最大尿流速為10.3毫升/秒。 兩個時間點的餘尿量分別是80毫升與92毫升，平均血清中的攝護腺抗原從基準點的6.0 ng/ml 降到3個月時的5.0 ng/ml(p=0.04)。 攝護腺內注射A型肉毒桿菌素可縮小攝護腺體積，可能對於患有良性攝護腺肥大伴隨難治的尿滯留又不適合手術的患者是種有前瞻性的治療。 |
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| abstract | To evaluate the effect of intraprostatic injection of botulinum toxin A (BoNTA) on prostate volume and refractory urinary retention in patients with benign prostatic enlargement. METHODS: Twenty-one men with benign prostatic enlargement on chronic indwelling catheter for at least 3 mo who were not candidates for surgery because of poor general condition received 200 U BoNTA in the transition zone by transrectal approach under ultrasound guidance. Patients were reevaluated at 1 and 3 mo posttreatment. RESULTS: Patients had a mean age of 80+/-2 yr. Injections were done without anaesthetic support as an outpatient procedure. No significant local effects occurred. Baseline prostate volume of 70+/-10ml decreased to 57+/-10ml (p<0.0006) at 1 mo and to 47+/-7ml (p=0.03 against 1 mo) at 3 mo. At 1 mo, 16 patients (76%) could resume voiding with a mean Q(max) of 9.0+/-1.2ml/s. At 3 mo, 17 patients (81%) voided with a mean Q(max) of 10.3+/-1.4ml/s. Residual urine was 80+/-19ml and 92+/-24ml at the two time points, respectively. Mean serum total PSA decreased from 6.0+/-1.1ng/ml at baseline to 5.0+/-0.9ng/ml at 3 mo (p=0.04). CONCLUSIONS: BoNTA injection into the prostate swiftly reduces prostate volume and may be a promising treatment for refractory urinary retention in patients with benign prostatic enlargement who are unfit for surgery. Future studies will determine the duration | |
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