内窥镜下前列腺消融术
已有关于应用不同能源的内窥镜下前列腺消融新技术的描述,包括激光摘出术和汽化术。一篇系统评价指出缺乏高质量研究,尽管输血率和住院治疗时长可能有所改善,但是总体结局与传统标准治疗(经尿道前列腺切除术)的相当。经尿道前列腺切除术仍是良性前列腺增生的首选外科治疗。[30]Lourenco T, Pickard R, Vale L, et al. Alternative approaches to endoscopic ablation for benign enlargement of the prostate: systematic review of randomized controlled trials. BMJ. 2008;30:337:a449.http://www.bmj.com/content/337/bmj.39575.517674.BEhttp://www.ncbi.nlm.nih.gov/pubmed/18595932?tool=bestpractice.com
新型支架
输尿管支架经常用于梗阻性尿道疾病的治疗。然而,其局限性包括:需要频繁更换支架,以及在恶性梗阻患者中失败率高。研发出的新支架包括永久性金属支架、[19]Li X, He Z, Yuan J, et al. Long-term results of permanent metallic stent implantation in the treatment of benign upper urinary tract occlusion. Int J Urol. 2007;14:693-698.http://www.ncbi.nlm.nih.gov/pubmed/17681057?tool=bestpractice.com强度更高且能更好地抵抗恶性梗阻的含管线支架[31]Nagele U, Kuczyk MA, Horstmann M, et al. Initial clinical experience with full-length metal ureteral stents for obstructive ureteral stenosis. World J Urol. 2008;26:257-262.http://www.ncbi.nlm.nih.gov/pubmed/18324407?tool=bestpractice.com以及治疗输尿管狭窄的自膨胀金属支架。[32]Liatsikos EN, Kagadis GC, Karnabatidis D, et al. Application of self-expandable metal stents for ureteroileal anastomotic strictures: long-term results. J Urol. 2007;178:169-173.http://www.ncbi.nlm.nih.gov/pubmed/17499298?tool=bestpractice.com尚未明确对这些支架的最恰当应用。