PDF
ePub
Citation
Print
Jin Sung Park, Gyeong Eun Min, Chang Hee You, Bumsik Hong
, Choung-Soo Kim, Hanjong Ahn, Tai Young Ahn
, Choung-Soo Kim, Hanjong Ahn, Tai Young Ahn
Abstract
Purpose
We prospectively compared the treatment outcomes of photo-selective vaporization of the prostate (PVP) with those of the gold standard transurethral resection of the prostate (TURP).
Materials and Methods
Between October 2004 and April 2006, a prospective clinical trial was performed with 131 and 41 patients treated by PVP and TURP, respectively. The efficacy of the two procedures were compared in terms of the International Prostate Symptom Score, quality of life score, peak urinary flow rate, postvoid residual volume, complications and perioperative outcomes at 1, 3, 6 and 12 months following treatment.
Results
The baseline characteristics of the two groups were similar. The operative times, catheter indwelling times and hospital stays were significantly shorter in the PVP group. All efficacy parameters were significantly improved in both groups compared to those obtained preoperatively. In addition, the degrees of improvement in the efficacy parameters were similar between the two groups within 12 months. With respect to the prostatic volume reduction, the difference between the pre- and post-PVP volumes during the study period was less than that of the TURP group (p<0.001). There were no differences in the overall complications between the two groups, with the exception of more common bleeding reguiring a transfusion and capsule perforation in the TURP group.
Conclusions
PVP provides excellent intraoperative and postoperative safety, and facilitates immediate relief from obstructive voiding symptoms; similarly to TURP, but has the advantages of shorter hospital stays and catheter indwelling times. The short-term treatment outcomes 12 months after PVP and TURP were comparable, with the exception of the prostatic volume reduction.
Figures and Tables
Table 3
Follow-up outcome parameters of the 172 patients
*comparison to the previous control, within each group, †comparison of PVP group and TURP group. IPSS: International Prostate Symptom Score, QoL: quality of life score, Qmax: maximum urinary flow rate, PVR: postvoid residual volume, PVP: photoselective vaporization of the prostate, TURP: transurethral resection of the prostate
References
1. Graversen PH, Grasser TC, Wasson JH, Hinman F Jr, Bruskewitz RC. Controversies about indications for transurethral resection of the prostate. J Urol. 1989. 141:475–481.
2. Wasson JH, Reda DJ, Bruskewitz RC, Elinson J, Keller AM, Henderson WG. A comparison of transurethral resection surgery with watchful waiting for moderate symptoms of benign prostatic hyperplasia: The Veterans Affairs Cooperative Study Group on Transurethral Resection of the Prostate. N Engl J Med. 1995. 332:75–79.
3. Malek RS, Kuntzman RS, Barrett DM. High-power potassium-titanyl-phosphate laser vaporization prostatectomy. J Urol. 2000. 163:1730–1733.
4. Hai MA, Malek RS. Photoselective vaporization of the prostate: initial experience with a new 80W KTP laser for the treatment of benign prostatic hyperplasia. J Endourol. 2003. 17:93–96.
5. Te AE, Malloy TR, Stein BS, Ulchaker JC, Nseyo UO, Hai MA, et al. Photoselective vaporization of the prostate for the treatment of benign prostatic hyperplasia: 12-month results from the first United States multicenter prospective trial. J Urol. 2004. 172:1404–1408.
6. Bachmann A, Schurch L, Ruszat R, Wyler SF, Seifert HH, Muller A, et al. Photoselective vaporization (PVP) versus transurethral resection of the prostate (TURP): a prospective bicentre study of perioperative morbidity and early functional outcome. Eur Urol. 2005. 48:965–971.
7. Malek RS, Barrett DM, Kuntzman RS. High-power potassium-titanyl-phosphate (KTP/532) laser vaporization prostatectomy: 24 hours later. Urology. 1998. 51:254–256.
8. Fitzpatrick JM, Mebust WK. Walsh PC, Retik AB, Vaughan ED, Wein AJ, editors. Minimally invasive and endoscopic management of benign prostatic hyperplasia. Campbell's urology. 2002. 8th ed. Philadelphia: Saunders;1379–1422.
9. 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.
10. Bouchier-Hayes DM, Anderson P, Appledorn SV, Bugeja P, Costello AJ. KTP laser versus transurethral resection: early results of a randomized trial. J Endourol. 2006. 20:580–585.
XML Download