A Short-term Comparative Study on Efficacy and Safety of Standard Transurethral Resection and High Power (80W) Potassium-Titanyl-Phosphate Laser Vaporization of the Prostate

Hwang, Eu Chang; Joo, Jae Sang; Min, Kyung Dai; Oh, Bong Ryoul; Kang, Taek Won; Kwon, Dong Deuk; Park, Kwangsung; Ryu, Soo Bang

Abstract

PURPOSE: Transurethral resection of the prostate (TURP) is the gold standard treatment for symptomatic benign prostate hyperplasia, but significant complications are associated with this procedure. The aim of this study was to compare the standard TURP with the high power (80W) potassium-titanyl-phosphate laser (KTP/532; Greenlights PVTM laser system; Laserscope, San Jose, USA) to elucidate the efficacy and safety of laser treatment.
MATERIALS AND METHODS
We performed comparative trials of 40 patients suffering with symptomatic bladder outlet obstruction due to benign prostatic hyperplasia from February 2005 to June 2005. Twenty patients were treated with TURP (Group I) and 20 patients were treated with KTP (Group II). All patients were assessed preoperatively and at an interval of 3 months postoperatively based on the International Prostate Symptom Score (IPSS), the quality of life (QoL) index, changes in maximum urinary flow rate (Qmax), and the postvoid residual urine (ml). The safety parameters we evaluated included the operative time (minutes), the postoperative catheterization time (day) and the blood loss (ml). The Kolmogorov- Smirnov & Shapiro-Wilk test, Student's t-test, Student's t-test (paired), and Fisher's Exact test were performed for statistical analysis.
RESULTS
The mean age of each group was 68.9+/-9.9 years (group 1) and 63.9+/-9.7 years (group II), and the prostate weight was 49.5+/-15.4cc and 45.0+/-17.3cc, respectively. The mean operation time was shorter for group II (27.7+/-13.6min) than for group I (48.1+/-22.6min) (p<0.05). The mean catheterization time was 5.6+/-1.82 and 1.36+/-1.64 days, respectively, (p<0.001). The blood loss was lower in group II (11.7+/-11.4ml) than in group I (181.9+/-168.17ml, respectively) (p<0.001).
CONCLUSIONS
In this preliminary short-term study, KTP Laser enucleation of the prostate was shown to be an effective alternative for treating benign prostate hyperplasia as compared with standard TURP.