日本人男性における携帯式尿流量計(P-Flowdiary®)を用いた排尿量/尿流量に関する年齢階層別ノモグラムの作成

Background: To develop a nomogram of urinary volume and flow based on the data of Japanese men without lower urinary tract symptoms and multiple flows per participant whose characteristics were clear. Methods: Overall, 101 Japanese male volunteers without lower urinary tract symptoms aged between 20 and 59 years were enrolled. A portable uroflowmeter (P-Flowdiary®) was used to record urinary information (flow rate and volume) for 2 successive days. The model (quadratic, linear, or logarithmic regression) most fit for the relationship between maximum flow rate and voided volume was determined. The maximum flow rate at > 150 mL was compared among the 20-29-, 30-39-, 40-49-, and 50-59-year age groups. Nomograms appropriate for the age groups were created. Results: The mean age, International Prostate Symptom Score, and Overactive Bladder Symptom Score were 38.5 years, 0.42, and 0.24, respectively. The quadratic regression model was the most fit because its mean coefficient determination was 0.93 ± 0.06. The mean maximum flow rate was significantly lower in the 50-59-year age group (21.8 ± 5.05 mL/s, P < 0.01) than in the younger groups (24.14 ± 4.94, 24.05 ± 6.99, and 24.64 ± 5.72 mL/s). The 2 nomograms are Y = 28.99 {1 - exp(- 0.01 × X)} and Y = 25.67 {1 - exp(- 0.01 × X)} for the 20-49- and 50-59-year age groups, respectively. Conclusions: The nomogram can predict maximum flow rate based on voided volume in Japanese men aged 20-59 years without lower urinary tract symptoms.博士（医学）・甲第858号・令和4年12月22日© 2022. The Author(s). Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data

More efficient vaporization by the 200-W Thulium laser system than by the GreenLight high-performance system (HPS) 120-W system

Aim: We retrospectively compared and evaluated the safety, efficacy, and 1-year outcomes of 200-W Thulium laser vaporization of the prostate (ThuVAP) and the GreenLight high-performance system (HPS) 120-W system for benign prostatic hyperplasia (BPH). Methods: Between February 2019 and December 2021, 137 patients with lower urinary tract symptoms secondary to BPH underwent ThuVAP. Between October 2014 and April 2019, 233 patients underwent GreenLight HPS 120-W vaporization of the prostate (HPS-PVP). Prostate-specific antigen (PSA) levels, International Prostate Symptom Scores (IPSS), quality of life (QOL) scores, overactive bladder symptom scores (OABSS), post-void residual (PVR), and maximum flow rates (Qmax) were evaluated before and 1, 3, 6, and 12 months after surgery.Results: Mean ages in the ThuVAP and HPS-PVP groups were 73.7 and 73.4 years, respectively. Prostate volumes (PV) were 77.0 and 61.4 mL (P &lt; 0.001), respectively. Significant improvements were observed in IPSS, QOL scores, OABSS, Qmax, and PVR in both groups 1 to 12 months after surgery. Laser and hospitalization times were significantly shorter and approximate tissue removal (ΔPV) was significantly larger in the ThuVAP group than in the HPS-PVP group (means, 49.4 min vs. 62.5 min, P &lt; 0.001, means, 4.9 days vs. 5.4 days, P = 0.007, means, 50.4 mLvs. 27.8 mL, P &lt; 0.001, respectively). Vaporization efficiency (ΔPV/laser time) was &gt; 2-fold higher in the ThuVAP group than in the HPS-PVP group (1.1 mL/min vs. 0.5 mL/min). There were significantly fewer postoperative complications in the ThuVAP group than in the HPS-PVP group (13.9% vs. 23.6%, P = 0.030).Conclusion: Both procedures are safe and useful for BPH obstruction. Based on shorter operating and hospitalization times, fewer complications, and more efficient tissue removal, ThuVAP is a more favorable and effective treatment than HPS-PVP