Klinik Araştırma
Efficacy and Safety of Prostate Radiofrequency Thermotherapy in Elderly Patients with BPO and Nocturia Resistant to Alpha-Blocker Therapy: An Observational Study
Öz
Aim: The purpose of this study is to investigate the effectiveness of the prostate bipolar radiofrequency
thermotherapy method on the complaint of nocturia and its safety in elderly patients.
Material and Methods: The post-procedural results of 100 patients over the age of 65 with complaints of
refractory nocturia were examined. The patients' pre-procedural Qmax values, prostate volumes, postvoid
residual amounts, IPSS scores, frequency of nocturia, and associated quality of life questionnaire
scores were recorded and compared with the results at the 3rd month after the procedure.
Results: The pre-procedural and post-procedural nocturia frequencies of the patients were consecutively
4.1 (2-13) times and 2.1 (0-10)times (p=0.002). There were significant improvements in the N-QOL
scores of the patients by 1.70±0.7 and in their discomfort caused by voiding at night (p<0.001). The
mean QOL score of the patients before the procedure was 4.2 (1-4), whereas it was calculated as 2.5
(1-5) 3 months after the procedure.
Conclusion: It was observed that this treatment method provided a significant improvement in terms
of nocturia in patients over the age of 65 and a positive effect on their quality of life. It is thought that it
can be a more effective and safer method in comparison to treatments that can have side effects or are
not suitable for elderly patients.
Anahtar Kelimeler
Kaynakça
- 1. Barkin J. Nocturia: diagnosis and management for the primary care physicians. Can J Urol 2016; 23: 16-19.
- 2. Xue Z, Lin Y, Jiang Y, Wei N, Bi J. The evaluation of nocturia in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia and the analysis of the curative effect after medical or placebo therapy for nocturia: a randomized placebo-controlled study. BMC Urol 2018; 18: 115.
- 3. Wolff DT, Adler KA, Weinstein CS, Weiss JP. Managing Nocturia in Frail Older Adults. Drugs Aging 2021; 38: 95-109.
- 4. Osman NI, Chapple CR, Wein AJ. Nocturia: Current concepts and future perspectives. Acta Physiol (Oxf) 2013;207:53-65.
- 5. Pesonen JS, Cartwright R, Vernooij RWM, Aoki Y, Agarwal A, Mangera A, Markland AD, Tsui JF, Santti H, Griebling TL, Pryalukhin AE, Riikonen J, Tähtinen RM, Vaughan CP, Johnson TM 2nd, Auvinen A, Heels-Ansdell D, Guyatt GH, Tikkinen KAO. The Impact of Nocturia on Mortality: A Systematic Review and Meta-Analysis. J Urol 2020;203:486-495.
- 6. Bae JH, Kim SW, Chung BH, Kim JH, Kim CS, Lee HM, Lee KS, Yoo TK, Kim SI, Byun SS, Lee JY. Desmopressin add-on therapy for refractory nocturia in men receiving α-blockers for lower urinary tract symptoms. J Urol 2013;190:180-186.
- 7. van Doorn B, Bosch JL. Nocturia in older men. Maturitas 2012;71:8-12.
- 8. Diri MA, Gul M. Bipolar prostate thermotherapy for the improvement of chronic prostatitis symptoms and ejaculation problems. Aging Male 2020;23:1004-1008.
- 9. Benli E, Yuce A, Nalbant I, Cirakoglu A, Yazici I. Can transurethral thermotherapy save elderly patients with benign prostatic obstruction and high ASA score? Aging Male 2020;23:1316-1320.
- 10. Chow PM, Chuang YC, Hsu KCP, Shen YC, Hsieh AW, Liu SP. Impacts of nocturia on quality of life, mental health, work limitation, and health care seeking in China, Taiwan and South Korea (LUTS Asia): Results from a cross-sectional, populationbased study. J Formos Med Assoc 2022;121:285-293.
- 11. Kim KH, Ko YH, Song PH, Kim TH, Kim BS. The prostatic urethral angle can predict the response to alpha adrenoceptor antagonist monotherapy for treating nocturia in men with lower urinary tract symptom: A multicenter study. Prostate Int 2016;4:30-35.
- 12. Dani H, Esdaille A, Weiss JP. Nocturia: aetiology and treatment in adults. Nat Rev Urol 2016;13:573-583.
- 13. Kupelian V, Fitzgerald MP, Kaplan SA, Norgaard JP, Chiu GR, Rosen RC. Association of nocturia and mortality: results from the Third National Health and Nutrition Examination Survey. J Urol 2011;185:571-577.
- 14. Mobley DF, Baum N. Etiology, evaluation, and management of nocturia in elderly men and women. Postgrad Med 2014;126:147-153.
- 15. Eisenhardt A, Schneider T, Cruz F, Oelke M. Consistent and significant improvement of nighttime voiding frequency (nocturia) with silodosin in men with LUTS suggestive of BPH: pooled analysis of three randomized, placebo-controlled, double-blind phase III studies. World J Urol 2014;32:1119- 1125.
- 16. Levin RM, Monson FC, Haugaard N, Buttyan R, Hudson A, Roelofs M, Sartore S, Wein AJ. Genetic and cellular characteristics of bladder outlet obstruction. Urol Clin North Am 1995;22:263-283.
- 17. Kim KS, Choi SW, Bae WJ, Kim SJ, Cho HJ, Hong SH, Lee JY, Hwang TK, Kim SW. Efficacy of a vaporization-resection of the prostate median lobe enlargement and vaporization of the prostate lateral lobe for benign prostatic hyperplasia using a 120-W GreenLight high-performance system laser: the effect on storage symptoms. Lasers Med Sci 2015;30:1387-1393.
- 18. Wagg A, Andersson KE, Cardozo L, Chapple C, Kirby M, Kelleher C, Lose G, Milsom I. Nocturia: morbidity and management in adults. Int J Clin Pract 2005;59:938-945.
- 19. Kim JC, Cho KJ, Lee JG, Seo JT, Kim DY, Oh SJ, Lee KS, Choo MS, Lee JZ. Efficacy and Safety of Desmopressin Add-On Therapy for Men with Persistent Nocturia on α-Blocker Monotherapy for Lower Urinary Tract Symptoms: A Randomized, Double-Blind, Placebo Controlled Study. J Urol 2017;197:459-464.
- 20. Yokoyama O, Tsujimura A, Akino H, Segawa N, Tamada S, Oguchi N, Kitagawa Y, Tsuji H, Watanabe A, Inamoto T, Shimizu N, Fujiuchi Y, Katsuoka Y, Azuma H, Matsuda T, Namiki M, Uemura H, Okuyama A, Nonomura N, Fuse H, Nakatani T. Add-on anticholinergic therapy for residual nocturia in patients with lower urinary tract symptoms receiving α1-blocker treatment: a multi-centre, prospective, randomised study. World J Urol 2015;33:659-667.
- 21. Kakizaki H, Lee KS, Yamamoto O, Jong JJ, Katou D, Sumarsono B, Uno S, Yamaguchi O. Mirabegron Add-on Therapy to Tamsulosin for the Treatment of Overactive Bladder in Men with Lower Urinary Tract Symptoms: A Randomized, Placebocontrolled Study (MATCH). Eur Urol Focus 2020;6:729-737.
- 22. Oelke M, Roehrborn CG, D’Ancona C, Wilson TH, Castro R, Manyak M. Nocturia improvement in the combination of Avodart(®) and tamsulosin (CombAT) study. World J Urol 2014;32:1133-1140.
- 23. Kujubu DA, Aboseif SR. An overview of nocturia and the syndrome of nocturnal polyuria in the elderly. Nat Clin Pract Nephrol 2008;4:426-435.
- 24. Deng W, Zhang C, Jiang H, Li Y, Zhu K, Liu X, Chen L, Liu W, Guo J, Zhou X, Fu B, Wang G. Transvesical versus posterior approach to retzius-sparing robot-assisted radical prostatectomy: a retrospective comparison with a 12-month follow-up. Front Oncol 2021;11:641887.
- 25. Johnson TM 2nd, Markland AD, Goode PS, Vaughan CP, Colli JL, Ouslander JG, Redden DT, McGwin G, Burgio KL. Efficacy of adding behavioural treatment or antimuscarinic drug therapy to α-blocker therapy in men with nocturia. BJU Int 2013;112:100-108.
- 26. Weiss JP, Blaivas JG, Bliwise DL, Dmochowski RR, Dubeau CE, Lowe FC, Petrou SP, Van Kerrebroeck PE, Rosen RC, Wein AJ. The evaluation and treatment of nocturia: a consensus statement. BJU Int 2011;108:6-21.
- 27. de Wildt MJ, Wagrell L, Larson TR, Eliasson T. Clinical results of microwave thermotherapy for benign prostatic hyperplasia. J Endourol 2000;14:651-656.
- 28. Weiss JP, Juul KV, Wein AJ. Management of nocturia: the role of antidiuretic pharmacotherapy. Neurourol Urodyn 2014;33:S19-S24.
Prostat Radyofrekans Termoterapinin Alfa Bloker Tedaviye Dirençli Noktürisi Olan BPO' lu Yaşlı Hastalarda Etkinliği ve Güvenliği: Gözlemsel Çalışma
Öz
Amaç: Bu çalışmanın amacı yaşlı hastalarda bipolar radyofrekans prostat termoterapi yönteminin
nokturi şikayeti üzerine etkinliğini ve güvenliğini incelemektir.
Gereç ve Yöntemler: Altmış beş yaş üstü ve dirençli nokturi şikayeti olan 100 hastanın işlem sonrası
sonuçları incelendi. Hastaların, işlem öncesi Qmax, prostat volümleri, işeme sonrası rezidü miktarı,
IPSS skorları, nokturi frekansı ve Nocturia Quality of Life sorgulama formu kaydedilip işlem sonrası 3.
ay sonuçları ile karşılaştırıldı.
Bulgular: Nokturi sıklığı ortalama 4,1 (2-13) kez görülürken işlem sonrası bu sayı 2,1 (0-10)’ya geriledi
(p=0,002). N-QOL yaşam kalitesi formunda 1,70±0,7 oranında ve gece idrara çıkmanın vermiş olduğu
rahatsızlıklarda anlamlı iyileşme görüldü (p<0,001). Hastaların işlem öncesinde yaşam kalitesi indeksi
skoru ortalama 4,2 (1-4) iken üçüncü ayda 2,5 (1-5) olarak hesaplandı.
Sonuç: Bu tedavi yönteminin 65 yaş üzeri hastalarda nokturi açısından anlamlı derecede iyileşme, hastaların yaşam kalitelerine pozitif
yönde etki sağladığı görüldü. Yaşlı hastalarda yan etkisi olabilen veya kullanımı uygun olmayan tedavilere göre daha etkili ve güvenilir bir
yöntem olabileceği düşünülmektedir
Anahtar Kelimeler
Kaynakça
- 1. Barkin J. Nocturia: diagnosis and management for the primary care physicians. Can J Urol 2016; 23: 16-19.
- 2. Xue Z, Lin Y, Jiang Y, Wei N, Bi J. The evaluation of nocturia in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia and the analysis of the curative effect after medical or placebo therapy for nocturia: a randomized placebo-controlled study. BMC Urol 2018; 18: 115.
- 3. Wolff DT, Adler KA, Weinstein CS, Weiss JP. Managing Nocturia in Frail Older Adults. Drugs Aging 2021; 38: 95-109.
- 4. Osman NI, Chapple CR, Wein AJ. Nocturia: Current concepts and future perspectives. Acta Physiol (Oxf) 2013;207:53-65.
- 5. Pesonen JS, Cartwright R, Vernooij RWM, Aoki Y, Agarwal A, Mangera A, Markland AD, Tsui JF, Santti H, Griebling TL, Pryalukhin AE, Riikonen J, Tähtinen RM, Vaughan CP, Johnson TM 2nd, Auvinen A, Heels-Ansdell D, Guyatt GH, Tikkinen KAO. The Impact of Nocturia on Mortality: A Systematic Review and Meta-Analysis. J Urol 2020;203:486-495.
- 6. Bae JH, Kim SW, Chung BH, Kim JH, Kim CS, Lee HM, Lee KS, Yoo TK, Kim SI, Byun SS, Lee JY. Desmopressin add-on therapy for refractory nocturia in men receiving α-blockers for lower urinary tract symptoms. J Urol 2013;190:180-186.
- 7. van Doorn B, Bosch JL. Nocturia in older men. Maturitas 2012;71:8-12.
- 8. Diri MA, Gul M. Bipolar prostate thermotherapy for the improvement of chronic prostatitis symptoms and ejaculation problems. Aging Male 2020;23:1004-1008.
- 9. Benli E, Yuce A, Nalbant I, Cirakoglu A, Yazici I. Can transurethral thermotherapy save elderly patients with benign prostatic obstruction and high ASA score? Aging Male 2020;23:1316-1320.
- 10. Chow PM, Chuang YC, Hsu KCP, Shen YC, Hsieh AW, Liu SP. Impacts of nocturia on quality of life, mental health, work limitation, and health care seeking in China, Taiwan and South Korea (LUTS Asia): Results from a cross-sectional, populationbased study. J Formos Med Assoc 2022;121:285-293.
- 11. Kim KH, Ko YH, Song PH, Kim TH, Kim BS. The prostatic urethral angle can predict the response to alpha adrenoceptor antagonist monotherapy for treating nocturia in men with lower urinary tract symptom: A multicenter study. Prostate Int 2016;4:30-35.
- 12. Dani H, Esdaille A, Weiss JP. Nocturia: aetiology and treatment in adults. Nat Rev Urol 2016;13:573-583.
- 13. Kupelian V, Fitzgerald MP, Kaplan SA, Norgaard JP, Chiu GR, Rosen RC. Association of nocturia and mortality: results from the Third National Health and Nutrition Examination Survey. J Urol 2011;185:571-577.
- 14. Mobley DF, Baum N. Etiology, evaluation, and management of nocturia in elderly men and women. Postgrad Med 2014;126:147-153.
- 15. Eisenhardt A, Schneider T, Cruz F, Oelke M. Consistent and significant improvement of nighttime voiding frequency (nocturia) with silodosin in men with LUTS suggestive of BPH: pooled analysis of three randomized, placebo-controlled, double-blind phase III studies. World J Urol 2014;32:1119- 1125.
- 16. Levin RM, Monson FC, Haugaard N, Buttyan R, Hudson A, Roelofs M, Sartore S, Wein AJ. Genetic and cellular characteristics of bladder outlet obstruction. Urol Clin North Am 1995;22:263-283.
- 17. Kim KS, Choi SW, Bae WJ, Kim SJ, Cho HJ, Hong SH, Lee JY, Hwang TK, Kim SW. Efficacy of a vaporization-resection of the prostate median lobe enlargement and vaporization of the prostate lateral lobe for benign prostatic hyperplasia using a 120-W GreenLight high-performance system laser: the effect on storage symptoms. Lasers Med Sci 2015;30:1387-1393.
- 18. Wagg A, Andersson KE, Cardozo L, Chapple C, Kirby M, Kelleher C, Lose G, Milsom I. Nocturia: morbidity and management in adults. Int J Clin Pract 2005;59:938-945.
- 19. Kim JC, Cho KJ, Lee JG, Seo JT, Kim DY, Oh SJ, Lee KS, Choo MS, Lee JZ. Efficacy and Safety of Desmopressin Add-On Therapy for Men with Persistent Nocturia on α-Blocker Monotherapy for Lower Urinary Tract Symptoms: A Randomized, Double-Blind, Placebo Controlled Study. J Urol 2017;197:459-464.
- 20. Yokoyama O, Tsujimura A, Akino H, Segawa N, Tamada S, Oguchi N, Kitagawa Y, Tsuji H, Watanabe A, Inamoto T, Shimizu N, Fujiuchi Y, Katsuoka Y, Azuma H, Matsuda T, Namiki M, Uemura H, Okuyama A, Nonomura N, Fuse H, Nakatani T. Add-on anticholinergic therapy for residual nocturia in patients with lower urinary tract symptoms receiving α1-blocker treatment: a multi-centre, prospective, randomised study. World J Urol 2015;33:659-667.
- 21. Kakizaki H, Lee KS, Yamamoto O, Jong JJ, Katou D, Sumarsono B, Uno S, Yamaguchi O. Mirabegron Add-on Therapy to Tamsulosin for the Treatment of Overactive Bladder in Men with Lower Urinary Tract Symptoms: A Randomized, Placebocontrolled Study (MATCH). Eur Urol Focus 2020;6:729-737.
- 22. Oelke M, Roehrborn CG, D’Ancona C, Wilson TH, Castro R, Manyak M. Nocturia improvement in the combination of Avodart(®) and tamsulosin (CombAT) study. World J Urol 2014;32:1133-1140.
- 23. Kujubu DA, Aboseif SR. An overview of nocturia and the syndrome of nocturnal polyuria in the elderly. Nat Clin Pract Nephrol 2008;4:426-435.
- 24. Deng W, Zhang C, Jiang H, Li Y, Zhu K, Liu X, Chen L, Liu W, Guo J, Zhou X, Fu B, Wang G. Transvesical versus posterior approach to retzius-sparing robot-assisted radical prostatectomy: a retrospective comparison with a 12-month follow-up. Front Oncol 2021;11:641887.
- 25. Johnson TM 2nd, Markland AD, Goode PS, Vaughan CP, Colli JL, Ouslander JG, Redden DT, McGwin G, Burgio KL. Efficacy of adding behavioural treatment or antimuscarinic drug therapy to α-blocker therapy in men with nocturia. BJU Int 2013;112:100-108.
- 26. Weiss JP, Blaivas JG, Bliwise DL, Dmochowski RR, Dubeau CE, Lowe FC, Petrou SP, Van Kerrebroeck PE, Rosen RC, Wein AJ. The evaluation and treatment of nocturia: a consensus statement. BJU Int 2011;108:6-21.
- 27. de Wildt MJ, Wagrell L, Larson TR, Eliasson T. Clinical results of microwave thermotherapy for benign prostatic hyperplasia. J Endourol 2000;14:651-656.
- 28. Weiss JP, Juul KV, Wein AJ. Management of nocturia: the role of antidiuretic pharmacotherapy. Neurourol Urodyn 2014;33:S19-S24.
Toplam 28 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Ağustos 2023 |
| Kabul Tarihi | 17 Ağustos 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 7 Sayı: 2 |
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