World J Mens Health.  2012 Dec;30(3):160-165.

Can 80 W KTP Laser Vaporization Effectively Relieve the Obstruction in Benign Prostatic Hyperplasia?: A Nonrandomized Trial

• Han DH
• Choo SH
• Chung JW
• Hong JH
• Lee SW

Abstract

PURPOSE
There is little data evaluating the changes of severity of bladder outlet obstruction after 80 W-potassium-titanyl-phosphate (KTP) photoselective laser vaporization prostatectomy (PVP) by pressure-flow study. We evaluated the efficacy of PVP to relieve the obstruction in benign prostate hyperplasia (BPH) compared with transurethral resection of the prostate (TURP).
MATERIALS AND METHODS
This is a prospective, non-randomized single center study. The inclusion criteria were as follows: Men suffering from lower urinary tract symptoms (LUTS) secondary to BPH, age > or =50 years, International Prostatic Symptom Score (IPSS) > or =13, maximum flow rate (Qmax) < or =15 ml/s, and ability to give fully informed consent. Patients with neurogenic cause or detrusor underactivity were excluded. The IPSS, bother score, Qmax, postvoid residual volume (PVR), detrusor pressure at maximum flow rate (PdetQmax), bladder outlet obstruction index (BOOI), and prostate volume were measured before and 6 months after surgery and compared between PVP and TURP.
RESULTS
Sixty-seven patients (53 in PVP, 14 in TURP) were evaluable. In both groups, the IPSS, bother score, Qmax, and PVR had significantly improved (p<0.05), and there were no differences between the changes in those parameters. PVP could effectively reduce the PdetQmax, prostate volume, and BOOI from baseline (from 68.7+/-23.3 to 40.6+/-11.2 cmH2O, 49.5+/-16.3 to 31.3+/-12.1 ml, 49.8+/-25.6 to 9.8+/-20.7), similar to TURP. There were no differences in postoperative PdetQmax, prostate volume, or BOOI between the two groups. The percentage of patients with BOOI > or =40 was decreased from 64% to 4% in the PVP group and from 86% to 14% in the TURP group.
CONCLUSIONS
PVP could reduce the prostate volume effectively and relieve bladder outlet obstruction similar to TURP by the 6-month follow up in men with BPH.

Keyword

Prostatic hyperplasia; KTP lasers; Transurethral resection of prostate; Urinary bladder neck obstruction

MeSH Terms

Follow-Up Studies
Humans
Hyperplasia
Informed Consent
Laser Therapy
Lasers, Solid-State
Lower Urinary Tract Symptoms
Male
Prospective Studies
Prostate
Prostatectomy
Prostatic Hyperplasia
Residual Volume
Stress, Psychological
Transurethral Resection of Prostate
Urinary Bladder Neck Obstruction
Volatilization

Figure

• 

  Fig. 1 Changes in prostate volume, PdetQmax, and BOOI in PVP and TURP group from baseline to 6 months follow up. White bars represent baseline and black bars 6 months follow up. PVP: photoselective laser vaporization prostatectomy, TURP: transurethral resection of the prostate, PdetQmax: detrusor pressure at maximum flow rate, BOOI: bladder outlet obstruction Index. *p<0.05.

• 

  Fig. 2 Change in obstructive parameters - PdetQmax, BOOI prevs. post-treatment. The values were adjusted using baseline values as covariates. The white bars represent the PVP group and black bars, the TURP group. PVP: photoselective laser vaporization prostatectomy, TURP: transurethral resection of the prostate, BOOI: bladder outlet obstruction index, PdetQmax: detrusor pressure at maximum flow rate, p: group comparisons of improvement rates after treatment.

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