Journal List > Korean J Urol > v.48(8) > 1004983

TOOLS
Hwang, Cho, Lee, and Hong: Comparative Analysis of Short-term Efficacy and Complication of Photoselective Vaporization for Benign Prostatic Hyperplasia which was Classified by Prostate Size
Original Article
Korean Journal of Urology

Korean Journal of Urology 2007; 48(8): 826-831.

Published online: 31 August 2007

DOI: https://doi.org/10.4111/kju.2007.48.8.826

Comparative Analysis of Short-term Efficacy and Complication of Photoselective Vaporization for Benign Prostatic Hyperplasia which was Classified by Prostate Size

Chun Ha Hwang, Chang Keun Cho1, Young Keun Lee1, Sung Joo Hong

Department of Urology, National Medical Center, Seoul, Korea.

1Department of Urology, Evergreen Urologic Clinic, Seoul, Korea.

Corresponding author (goldfig1@nate.com)

Received 18 May 2007       Accepted 2 July 2007

Copyright © 2007 The Korean Urological Association

Abstract

Purpose

This study was conducted to compare the short term clinical efficacy and complications of photoselective vaporization for benign prostatic hyperplasia (BPH), which was classified by the prostate size.

Materials and Methods

The clinical data of 309 men with BPH, who had undergone photoselective vaporization for prostate (PVP) using potassium-titanyl-phosphate (KTP) laser, between January 2005 and December 2006, were retrospectively analyzed. All patients were classified into three groups by their prostate size (<40cc; group I, 40-60cc; group II, >60cc; group III). The clinical efficacy of each group was compared in terms of the International Prostate Symptom Score (IPSS), quality of life (QoL) index, changes in the maximum urinary flow rate (Qmax), postvoid residual urine (PVR), complications and postoperative outcomes. The mean follow-up period was 6.4 months.

Results

The postoperative parameters were significantly improved in all patients (p<0.05). With respect to each of the three classified groups, the postoperative parameters of each group were also significantly improved (p<0.05). However, in group III, the postoperative IPSS and QoL index were lower than the average value. Especially, the items for frequency, nocturia and urgency of the IPSS resulted in bad grades. The rate of complications in group III were higher than those in groups I and II, such as urinary retention, delayed hematuria, urethral stricture and bladder neck contracture.

Conclusions

Despite the excellence of KTP, careful consideration must be given when the operation is performed on patients with a large prostate size.

Keywords: Vaporization, Benign prostatic hyperplasia, Complications

Figures and Tables

Fig. 1
Pre- and postoperative grades of the International Prostate Symptom Score; comparing the preoperative score, patients with a prostate size greater than 60cc, items 2, 4 and 7 of the postoperative score were high rather than low.
kju-48-826-g001
Table 1
Preoperative characteristics of the 309 patients
kju-48-826-i001

PSA: prostate-specific antigen, TRUS: transrectal ultrasonography, IPSS: International Prostate Symptom Score, QoL: quality of life score, Qmax: maximum urinary flow rate, PVR: postvoid residual volume

Table 2
Postoperative outcomes of the 309 patients
kju-48-826-i002

p-value: comparison to the preoperative data, within each group, IPSS: International Prostate Symptom Score, QoL: quality of life score, Qmax: maximum urinary flow rate, PVR: postvoid residual volume

Table 3
Perioperative outcomes of the 309 patients
kju-48-826-i003
Table 4
Adverse events related to PVP
kju-48-826-i004

References

1. McNeal J. Pathology of benign prostatic hyperplasia, insight into etiology. Urol Clin North Am. 1990. 17:477–486.
2. Barber NJ, Muir GH. High-power KTP laser prostatectomy: the new challenge to transurethral resection of the prostate. Curr Opin Urol. 2004. 14:21–25.
3. Hwang EC, Joo JS, Min KD, Oh BR, Kang TW, Kwon DD, et al. 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. Korean J Urol. 2005. 46:1251–1255.
4. Sandhu JS, Ng C, Vanderbrink BA, Egan C, Kaplan SA, Te AE. High-power potassium-titanyl-phosphate photoselective laser vaporization of prostate for treatment of benign prostatic hyperplasia in men with large prostates. Urology. 2004. 64:1155–1159.
5. Monoski MA, Gonzalez RR, Sandhu JS, Reddy B, Te AE. Urodynamic predictors of outcomes with photoselective laser vaporization prostatectomy in patients with benign prostatic hyperplasia and preoperative retention. Urology. 2006. 68:312–317.
6. Reich O, Bachmann A, Siebels M, Hofstetter A, Stief CG, Sulser T. High power (80W) pottasium-titanyl-phosphate laser vaporization of the prostate in 66 high risk patients. J Urol. 2005. 173:158–160.
7. Rutkow IM. Urological operations in the United States: 1979 to 1984. J Urol. 1986. 135:1206–1208.
8. Lindner A, Siegel YI, Saranga R, Korzcak D, Matzkin H, Braf Z. Complications in hyperthermia treatment of benign prostatic hyperplasia. J Urol. 1990. 144:1390–1392.
9. Issa MM. Laser therapy for BPH. AUA Update Series. 2003. 22:90–95.
10. Aaron P. Perlmutter. New uses of energy for the treatment of BPH. AUA Update Series. 1998. 16:249–256.
11. Te AE, Malloy TR, Stein BS, Ulchaker JC, Nseyo UO, Hai MA, et al. Photoselective vaporization of the prostate treatment of benign prostatic hyperplasia: 12-month results from the first United States multicenter prospective trial. J Urol. 2004. 172:1404–1408.
12. Bouchier-Hayes DM, Anderson P, Van Appledorn S, Bugeja P, Costello AJ. KTP laser versus transurethral resection: early results of randomized trial. J Endourol. 2006. 20:580–585.
13. Park JS, Min GE, You CH, Hong B, Kim CS, Ahn H, et al. Comparison of treatment outcomes between photoselective vaporization and transurethral resection of the prostate for benign prostatic hyperplasia. Korean J Urol. 2007. 48:297–303.
14. Malek RS, Kuntzman RS, Barrett DM. High power potassium-titanyl-phosphate laser vaporization prostatectomy. J Urol. 2000. 163:1730–1733.
15. Krishnamoorthy R, Barber NJ, Walsh K, Thompson PM, Muir GH. Open prostatectomy - is it going to be a textbook operation as huge prostates>100ml can be treated with Greenlight PVP. BJU Int. 2006. 97:Suppl. 77.
16. Malek RS, Kuntzman RS, Barrett DM. Photoselective potassium-titanyl-phosphate laser vaporization of the benign obstructive prostate: observations on long-term outcomes. J Urol. 2005. 174:1344–1348.
17. Rajbabu K, Muir GH. Greenlight photoselective vaporization of prostate-a technical review. Prostate Cancer Prostatic Dis. 2007. 10:Suppl 1. S6–S9.
18. Malek RS, Nahen K. Photoselective vaporization of the prostate: KTP laser therapy of obstructive benign prostatic hyperplasia. AUA Update Series. 2004. 23:153.
19. Verger-Kuhnke AB, Reuter MA, Epple W, Ungemach G, Beccaria ML. Photoselective vaporization with the 80-watt KTP-laser (kalium-titanyl-phosphate) and low-hydraulic-pressure TURP in the treatment of BPH: our experience with 230 cases. Arch Esp Urol. 2007. 60:167–177.
TOOLS
Similar articles