The Efficacy and Safety of KTP Photoselective Vaporization of the Prostate for the Treatment of Benign Prostatic Hyperplasia: The 2-year Results

Seol Ho Choo; Deok Hyun Han; Sung-Won Lee

doi:10.4111/kju.2008.49.9.831

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Choo, Han, and Lee: The Efficacy and Safety of KTP Photoselective Vaporization of the Prostate for the Treatment of Benign Prostatic Hyperplasia: The 2-year Results

Original Article

Korean Journal of Urology

Korean Journal of Urology 2008; 49(9): 831-836.

Published online: 30 September 2008

DOI: https://doi.org/10.4111/kju.2008.49.9.831

The Efficacy and Safety of KTP Photoselective Vaporization of the Prostate for the Treatment of Benign Prostatic Hyperplasia: The 2-year Results

Seol Ho Choo, Deok Hyun Han, Sung-Won Lee

Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

drsw.lee@samsung.com

Received 18 March 2008 Accepted 25 July 2008

Abstract

Purpose

This study was conducted to evaluate, with using the 2-year follow-up data, the clinical efficacy and safety of performing photoselective vaporization of the prostate (PVP) for the treatment of symptomatic benign prostatic hyperplasia (BPH).

Materials and Methods

We analyzed the clinical data of 104 men with symptomatic BPH and who had undergone PVP. The efficacy parameters were the changes from baseline of the International Prostate Symptom Score (IPSS), the quality of life (QoL) score, the maximum urinary flow rate (Qmax) and the postvoid residual volume (PVR). The patients were evaluated preoperatively and then at post-operative 1, 3, 6, 12 and 24 months. Their complications were also evaluated.

Results

The mean prostate volume was 45.6ml. The mean lasing time was 44.9 minutes and there was no significant blood loss or fluid absorption during or immediately after PVP. Significant improvements in the IPSS, the QoL score, the Qmax and the PVR were noted as early as 1 month after PVP treatment. After 24-month follow-up, the mean IPSS decreased from 22.4 to 9.9 (p < 0.0001) and the QoL score decreased from 4.4 to 2.3 (p < 0.0001), while the mean Qmax changed from 8.3 to 14.4ml/sec (p < 0.0001). The PVR decreased from 82.0 to 49.9ml (p=0.033). The complications were retrograde ejaculation (26.9%), transient catheterization (6.7%), transient dysuria (2.9%), bladder neck contracture (1.9%), urethral stricture (0.9%) and meatal stenosis (0.9%). 1 patient was diagnosed with prostate cancer 32 months after operation.

Conclusions

Significant improvements of the subjective and objective voiding parameters were achieved and these were sustainable for at least 2-year, with minimal complications, after PVP. PVP seems to be a safe and effective treatment for symptomatic BPH.

Keywords: Prostatic hyperplasia, Laser therapy, Treatment outcome

Figures and Tables

Table 1

Baseline characteristics of the patients

^*n=67, IPSS: International Prostate Symptom Score, QoL: quality of life, Qmax: maximum urinary flow rate, PVR: postvoid residual volume, BOOI: bladder outlet obstruction index, PSA: prostate-specific antigen

Table 2

Perioperative outcomes

Table 3

Postoperative follow-up outcome parameters

^*Comparison to preoperative values, IPSS: International Prostate Symptom Score, QoL: quality of life, Qmax: maximum urinary flow rate, PVR: postvoid residual volume

Table 4

Comparisons of the postoperative outcomes according to the size of the prostate

IPSS: International Prostate Symptom Score, QoL: quality of life, Qmax: maximum urinary flow rate, PVR: postvoid residual volume

Table 5

Postoperative complications

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