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Greenlight laser vaporization of the prostate: single-center experience and long-term results after 500 procedures

Ruszat, R. and Seitz, M. and Wyler, S. F. and Abe, C. and Rieken, M. and Reich, O. and Gasser, T. C. and Bachmann, A.. (2008) Greenlight laser vaporization of the prostate: single-center experience and long-term results after 500 procedures. European urology, Vol. 54. S. 893-901.

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Official URL: http://edoc.unibas.ch/dok/A6003516

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Abstract

BACKGROUND: Long-term data of photoselective vaporization of the prostate (PVP) for treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) is scanty. OBJECTIVE: Evaluate the long-term efficacy and the complication rate in 80-watt (W) PVP. DESIGN, SETTING, AND PARTICIPANTS: 500 consecutive patients with LUTS secondary to BPH underwent PVP between September 2002 and April 2007. The mean follow-up was 30.6+/-16.6 (5.2-60.6) mo. INTERVENTION: All patients underwent 80-W PVP performed by seven surgeons. MEASUREMENTS: We evaluated perioperative parameters, including operation time, delivered energy, changes of hemoglobin and serum sodium, catheterization, and hospitalization time as well as intraoperative and postoperative complications. Patients presenting for follow-up had data assessed on the International Prostate Symptom Score and quality-of-life questionnaire (IPPS-QoL), maximal flow rate (Q(max)), and post-voiding residual volume (Vres). RESULTS AND LIMITATIONS: Mean patient age was 71.4+/-9.6 (46-96) yr, with a mean preoperative prostate volume of 56.1+/-25.3 (10-180) ml. Mean operation time was 66.4+/-26.8 (10-160) min, and mean energy delivery was 206+/-94 (2.4-619.0) kJ. Despite ongoing oral anticoagulation in 45% of the patients (n=225), no severe intraoperative complications were observed. Mean catheterization and postoperative hospitalization time was 1.8+/-1.2 (0-10) and 3.7+/-2.9 (0-35) d, respectively. The mean IPSS after 3 yr was 8.0+/-6.2, the QoL score was 1.3+/-1.3, the Q(max) was 18.4+/-8.0 ml/s, and the Vres was 28+/-42 ml. The retreatment rate was 6.8%. Urethral and bladder neck strictures were observed in 4.4% and 3.6% of the patients, respectively. Localized prostate cancer was diagnosed during follow-up in six patients. CONCLUSION: PVP is a safe and effective procedure for treatment of LUTS secondary to BPH. Patients on ongoing oral anticoagulation can be safely operated on. PVP leads to an immedi and sustained improvement of subjective and objective voiding parameters. The late complication rate is comparable to that of transurethral electroresection of the prostate.
Faculties and Departments:03 Faculty of Medicine > Bereich Operative Fächer (Klinik) > Innere Organe > Urologie Kliniken BL (Gasser)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Operative Fächer (Klinik) > Innere Organe > Urologie Kliniken BL (Gasser)
03 Faculty of Medicine > Bereich Operative Fächer (Klinik) > Innere Organe > Urologie USB (Bachmann)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Operative Fächer (Klinik) > Innere Organe > Urologie USB (Bachmann)
UniBasel Contributors:Gasser, Thomas C. and Bachmann, Alexander and Wyler, Stephen
Item Type:Article, refereed
Bibsysno:Link to catalogue
Publisher:Elsevier
ISSN:0302-2838
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:08 Nov 2012 16:22
Deposited On:08 Nov 2012 16:13

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