（参考翻译）14.3 BPHnephrosis.pptVIP

Surgical Treatment Surgical Treatment Open Prostatectomy Not done routinely When prostate too large for TURP (100mL) Minimally Invasive  Surgical treatment TUMT-transurethral microwave therapy 经尿道微波热疗 TUNA- transurethral needle ablation 经尿道射频消融 Urinary Stents 尿道支架 Laser Prostatectomy-Holep holmium laser enucleation of the prostate 钬激光前列腺剜除术 Minimally Invasive  Surgical treatment TUMT(transurethral microwave therapy) Performed as a single outpatient 门诊的 visit under local anesthesia and an oral analgesic 口服镇痛药. Improves symptom scores and urinary flow rates 尿流率 Minimally Invasive  Surgical treatment TUNA (transurethral needle ablation) An office procedure performed under local anesthesia- improves symptom scores and urinary flow rates It uses specially designed catheter 导管 through which interstitial 间隙的 radio-frequency needles are deployed 展开 from the tip 尖端 of it. They will heat the tissue resulting in coagulative necrosis 凝固性坏死 The entire procedure lasts 30-60 minutes A catheter is left for 1-4 days after the procedure Minimally Invasive  Surgical treatment Intraurethral Stent Limited long term experience Increases urine flow rates but causes secondary obstruction by exuberant 丰富 granulation tissue 肉芽组织 growth through and around the stent Difficult to remove it; formation of bladder calculi in 50% of patients Usually for patients with limited life expectancy 预期寿命 that are not good surgical or anesthetic candidates 候选 Abandoned by most urologists Minimally Invasive  Surgical treatment Laser Therapy- “The wave of the future” Neodymium: yttrium-aluminium-garnet (Nd:YAG) -Visual Laser ablation of the Prostate The final result is coagulative necrosis of the prostatic urethra and adjacent inner prostatic tissue. The obstructive tissue starts to slough 4-8 weeks post-op leading to an open prostatic urethra ? Green light laser -Laser V