Clinical Outcomes Analysis with Efficacy and Safety of 120W High-Power System Laser Photoselective Vaporization of the Prostate

Yong Sun Choi; Su Jin Kim; Woong Jin Bae; Hyuk Jin Cho; Sung Hoo Hong; Ji Youl Lee; Tae Kon Hwang; Sae Woong Kim

doi:10.5534/kja.2011.29.1.69

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Choi, Kim, Bae, Cho, Hong, Lee, Hwang, and Kim: Clinical Outcomes Analysis with Efficacy and Safety of 120W High-Power System Laser Photoselective Vaporization of the Prostate

Original Article

Korean J Androl 2011;29(1):69-75.

Published online: 22 April 2011

DOI: https://doi.org/10.5534/kja.2011.29.1.69

Clinical Outcomes Analysis with Efficacy and Safety of 120W High-Power System Laser Photoselective Vaporization of the Prostate

Yong Sun Choi, Su Jin Kim, Woong Jin Bae, Hyuk Jin Cho, Sung Hoo Hong, Ji Youl Lee, Tae Kon Hwang, Sae Woong Kim

Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea

Received 17 March 201129 March 2011 Accepted 31 March 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Several studies and papers have reported good short-term results for using 120W HPS laser PVP. Here we report the short-term and longterm clinical outcomes analysis with efficacy and safety of 120W HPS laser PVP for the treatment of BPH.

Materials and Methods

We performed a retrospective clinical analysis of 357 patients, who underwent 120W HPS laser PVP for the treatment of BPH from April, 2009 to Feb. 2011. The IPSS, Qmax and PVR values were evaluated preoperatively and postoperatively.

Results

The mean age at the surgery; 70.35±8.28, mean prostate size; 46.56±21.11 ml, and mean PSA was 4.16±4.35 ng/ml. Mean operation time was 41.8±34.1 min, and mean lasing time was 19.8±11.3 min. Mean applied energy was 134,294.9±225,211.5 J. Thirty cases of co-operation were done. Mean catheter indwelling time was 0.84±0.36 day, and mean hospital stay was 1.1±0.2 day. The blood loss was minimal so transfusions were not needed. The baseline IPSS-sum; 19.61±9.13, QoL score; 4.28±1.02, Qmax; 7.94±5.51 ml/sec, PVR; 101.62±102.58 ml, At 1 month, IPSS-sum; 8.64±7.34, QoL score; 2.19±1.48, Qmax; 13.32±8.94 ml/sec, PVR; 32.54±46.07 ml was noted. At 12 months, IPSS-sum; 8.33±5.04, QoL score; 1.33±1.08, Qmax; 15.75±2.90 ml/sec, PVR; 21.56±31.28 ml was noted. Within 1 month of operation, 18 cases of dysuria and 27 cases of retention were reported but these were resolved with medication and observation. Compared with preoperative values, there were statistical improvements after the operation.

Conclusions

120W HPS laser showed statistical improvements after 1 month operation and these results were sustained for 12 months. Although limitations, our long term experience suggest that significant improvements in symptomatic and urodynamic outcomes of 120W HPS laser PVP.

Keywords: Laser therapy, Prostatic Hyperplasia, Laser Vaporization

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Fig. 1.

Postoperative IPSS scores F/U (∗p＜0.05). Postoperative International prostate symptom scores follow-up after 120W PVP within a follow-up of 12 months. Bars represent mean values of groups. Definition: ∗p＜0.05, IPSS: International prostate symptom score, QoL: quality of life. Statistic data information; Pre OP: n=357, 1 Mo: n=341, 3 Mo: n=301, 6 Mo: n=258, 12 Mo: n=219.

Fig. 2.

Postoperative Qmax F/U (∗p＜0.05). Postoperative Peak Flow follow-up after 120W PVP within a follow-up of 12 months. Bars represent mean value of group. Definition: ∗p ＜0.05, Qmax: peak flow. Statistic data information; Pre OP: n=357, 1 Mo: n=341, 3 Mo n=301, 6 Mo: n=258, 12 Mo: n=219.

Fig. 3.

Postoperative PVR F/U (∗p＜0.05). Postoperative Post-Voiding Residual volume follow-up after 120W PVP within a follow-up of 12 months. Bars represent mean value of group. Definition: ∗p＜0.05, PVR: Post-Voiding residual volume. Statistic data information; Pre OP: n=357, 1 Mo: n=341, 3 Mo: n=301, 6 Mo: n=258, 12 Mo: n=219.

Table 1.

Preoperative characteristics

	Mean±SD	Range
Age	70.35±8.28	47∼94
International prostate symptom score	19.61±9.13	7∼35
Voiding symptom score	12.3±4.96	4∼20
Storage symptom score	8.5±3.91	3∼15
Quality of life score	4.28±1.02	1∼6
Peak flow (ml/sec)	7.94±5.51	1.2∼32.8
Post-void residual volume (ml)	101.62±102.58	15∼250
Prostate volume (ml)	46.56±21.11	12.9∼205.0
Prostate specific antigen (ng/ml)	4.16±4.35	0.2∼423.7
Risk factor
Age over 70	193/357	54%
Other disease (Diabetes, Hypertension, etc)	182/357	51%
Anticoagulation medicatio	n 154/357	43%

Table 2.

Perioperative result

	Mean±SD	Range
Operative time (min)	41.8±34.1	13∼183
Lasing time (min)	19.8±11.3	7.5∼84.36
Total applied energy (J)	134,294.9±	2,508∼2,750,415
	225,211.5
Catheter indwelling time (day)	0.84±0.36	0.5∼2.0

Table 3.

Postoperative complications within 1 month

Adverse events	No. Pts	%
Dysuria (sterile)	18	5.0
Retention (recatheterization)	27	7.6

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