前立腺肥大症に対する超音波治療  [in Japanese] Efficacy of Transrectal Ultrasonic Physiotherapy Assessed in Management of Benign Prostatic Hypertrophy  [in Japanese]

高齢化社会を迎えて,前立腺肥大症症例の増加にともない,その治療法ことに保存的治療法の開発が必要とされ,各種検討がなされている。今回は,旧ソ連で開発された前立腺への超音波治療装置を用いて本症への応用を試みた。照射条件はパルス10ms,出力0.4/cm^2で,1日1回,連日照射7日間を1クールとした。まずパイロット試験として25例の治療を実施,自他覚的所見ともに約40%の改善をみた。さらに症例を拡大して,115例を対象に治療を行ったところ,自覚的所見はやはり40%前後の改善を示したが,他覚的には第一次治験ほどの改善を示さなかった。治療後6か月以降の追跡調査では,この治療後に手術療法が行われた群で,治療直後に比して治療後6か月以降で悪化した例が約70%と他の群に比して多い傾向を示した。一方,本治療後そのまま何の治療もせずに経過している群では,本治療後16%が時間の経過とともにさらに改善傾向を示したことが分かった。局所療法のため副作用の少ない治療法であり,照射条件や治療方式を変えて検討すれば,更に期待の持てる治療法といえよう。

In the era of an aging society, the development of a new strategy for the conservative treatment for benign prostatic hypertrophy (BPH) has long been anticipated. This prospective study was an effort to evaluate the effectiveness of transrectal ultrasonic physiotherapy (TRUP) for the symptomatic relief of BPH. Patients were treated with ultrasound beam irradiated from transrectally placed applicator which was developed in the former Soviet Union. The interval and intensity of the pulsed ultrasound applied were 10 ms and 0.4 W/cm^2, respectively. The treatment was performed once a day for 7 consecutive days. In the pilot trial (25 patients), clinical and symptomatic improvements were noted in a collective average of 10 patients (40%). Also in the second trial (115 patients), symptoms were allayed in approximately 40% (46) of the cases. Patients who needed surgical intervention after 6 months of TRUP showed a much higher incidence of aggravation in their obstructive symptoms (70%) than other groups. On the other hand symptoms improved with time after TRUP in 17% of the 42 patients who were followed without any other therapy. We conclude that TRUP for BPH is an effective conservative treatment with few side effects. Further investigation is warranted.