Photoselective vaporization of the prostate in the therapy of benign prostatic hyperplasia

Abstract 

Background

The recent progress in the area of laser technology has permitted the development of a highly effective method of laser adenomectomy called transurethral vaporization of the prostate (TUVP). This method utilizes a high power potassium-titanyl-phosphate (KTP) laser.

Methods

Forty patients with benign prostatic hyperplasia (BPH) were operated on by means of TUVP with an 80-watt high power KTP laser (GreenLight PV™, Laserscope^®, San Jose, CA) at the National Research Center for Urology during the period August 2005 to August 2007.

Results

The duration of the surgical intervention averaged 52.4min, while the mean time for the in-dwelling urethral catheter was 14h. Complications were mild and included short-term dysuria (12%) and short-term hematuria (8%). The results of the repeated evaluations performed in all of the patients at 1, 3, 6, and 12 months after TUVP were as follows: by 12 months, the International Prostate Symptom Score (IPSS) value dropped by 78% to 5 points, the Quality-of-Life (QoL) index improved by 50% to equal 2.6 points. The Q_max value rose by 112% to average 18.3ml/s, whereas the post-void residual urine volume decreased by 74% to average 22.1ml.

Conclusion

TUVP is a minimally invasive procedure that is not accompanied by the absorption of the lavage fluid or blood loss, allowing the hospitalization period to be considerably reduced, and in some cases allowing the intervention to be performed in an out-patient department or day hospital. Thus, the laser vaporization of the prostate is a worthy alternative to the conventional transurethral resection of the prostate (TUR). Further research into the long-term results of this surgical intervention would be of great help in the comprehensive assessment of its clinical efficacy.

Keywords: Benign prostatic hyperplasia, Photoselective vaporization, Prostate