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Prospective single-centre comparison of 120-W diode-pumped solid-state high-intensity system laser vaporization of the prostate and 200-W high-intensive diode-laser ablation of the prostate for treating benign prostatic hyperplasia

Ruszat, Robin and Seitz, Michael and Wyler, Stephen F. and Müller, Georg and Rieken, Malte and Bonkat, Gernot and Gasser, Thomas C. and Reich, Oliver and Bachmann, Alexander. (2009) Prospective single-centre comparison of 120-W diode-pumped solid-state high-intensity system laser vaporization of the prostate and 200-W high-intensive diode-laser ablation of the prostate for treating benign prostatic hyperplasia. BJU international, Vol. 104. pp. 820-825.

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Official URL: http://edoc.unibas.ch/dok/A6003699

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Abstract

OBJECTIVE: To evaluate the safety, efficacy and short-term outcome of a new 980 nm high-intensity diode (HiDi) laser (Limmer Laser, Berlin, Germany) system in comparison to the diode-pumped solid-state laser high-performance system (HPS; GreenLight(TM), AMS, Minnetonka, MI, USA) for treating benign prostatic hyperplasia (BPH) in a prospective non-randomized single-centre study. PATIENTS AND METHODS: From February to September 2007, 117 consecutive patients with lower urinary tract symptoms secondary to BPH were included; 62 patients were treated with 120-W HPS laser vaporization and 55 with 980-nm HiDi laser ablation of the prostate. We evaluated perioperative variables, and complications during and after surgery. Patients presenting for follow-up completed the International Prostate Symptom Score, and had their maximum urinary flow rate and postvoid residual urine volume measured. RESULTS: The mean (sd) age of the patients was 72.3 (8.8) years (HiDi) and 73.1 (10.8) years (HPS), with a mean preoperative prostate volume of 64.7 (29.7) and 67.4 (46.9) mL, respectively. The mean operative duration was comparable, at 56.4 (20.2) and 62.7 (36.3) min, respectively, whereas the mean energy delivery was significantly higher with the diode laser, at 313 (132) vs 187 (129) kJ (P > 0.001). For patients treated with the HPS the rate of visual impairment from bleeding was higher (0% vs 12.9%, P > 0.01), as was prostate capsule perforation (0% vs 4.8%, P < 0.05). Soon after surgery the rate of dysuria (23.6% vs 17.7%, P < 0.05) and transient urge incontinence (7.3% vs 0%; P > 0.05) was higher for the HiDi laser. During the follow-up there were higher rates of bladder neck stricture (14.5% vs 1.6%, P > 0.01), re-treatment (18.2% vs 1.6%, P > 0.01) and stress urinary incontinence (9.1% vs 0%; P > 0.05) for the HiDi laser group. CONCLUSION: Both systems investigated provide good tissue ablative properties. The HiDi laser at 980 nm is more favourable in terms of haemostasis. The penetration depths, resulting in coagulation necrosis and leading to increased re-treatment, bladder neck stricture and incontinence rates, were higher with the HiDi laser.
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
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Blackwell Science
ISSN:1464-4096
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:04 Jan 2013 08:38
Deposited On:04 Jan 2013 08:36

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