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Abstract
Purpose
This study was conducted to evaluate the quality of life and efficacy of treatment after 80 watts high power potassium-titanyl-phosphate laser vaporization for patients with a prostate volume greater than 40cc. We adopted the benign prostatic hyperplasia (BPH) quality of life (QoL)-K1 short form that was developed by the Korean Urological Association in 2001 to more accurately assess the quality of life of patients with BPH.
Materials and Methods
From July 2005 to March 2006, we performed KTP laser vaporization on a total of 38 patients with symptomatic benign prostatic hyperplasia of the prostate and all their prostate volumes were more than 40cc. All the patients were evaluated preoperatively and then again at 3 and 6 months postoperatively based on the International Prostate Symptom Score (IPSS), the maximum urinary flow rate (Qmax) and the postvoid residual urine (PVR). We conducted a survey of all the patients regarding BPH with using the QoL-K1 short form by means of mail and phone at a mean of 8.7 months (range: 5-12) postoperatively.
Results
The mean operation timewas 50.5 minutes (range: 20-120), and the mean duration of admission and catheterization were 2.9±0.4 days and 22.0±10.9 hours, respectively. The mean total score for the BPH QoL-K1 short form improved from 34.5 preoperatively to 22.5 at 6 months postoperatively (p<0.001). There was a significant improvement in the IPSS, Qmax and PVR after the operation, but there were no differences between these parameters at 3 months and 6 months after KTP laser vaporization. There was dysuria in 9 (24%) patients postoperatively and urinary tract infection occurred in 10 (26%) of all the patients.
Conclusions
This study showed that KTP laser vaporization was effective in patients with a prostate volume more than 40cc, and the procedure produced improvements in the IPSS, Qmax,PVR and the BPH QoL-K1 short form. Despite the high rate of dysuria and urinary tract infection, the patients treated with KTP laser showed satisfaction about the operation because of the shortened duration of both admission and catheterization.
Figures and Tables
Fig. 1
(A) Correlation curve between the prostate volume and the operation time (r2=0.695, p<0.001, as analyzed by Pearson's bivariate correlation analysis). (B) Correlation curve between the prostate volume and the applied energy (r2=0.390, p<0.001, as analyzed by Pearson's bivariate correlation analysis).
Fig. 2
Comparison of the preoperative and postoperative outcomes according to the benign prostatic hyperplasia (BPH) QoL-K1 short form. The BPH QoL-K1 short form is composed of 9 items that are related to lower urinary tract symptoms (LUTS) (Q 1-4), the physical (Q 5-6), emotional (Q 7), general health perception (Q 8), and sexual (Q 9) domains. The postoperative parameters of each domain improved from the preoperative parameters with statistical significance (all p-values<0.001, analyzed by chi-square test).
References
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