Laser prostatectomy performed with a right-angle firing neodymium:YAG laser fiber at 60 watts power setting.
A total of 50 patients with symptomatic bladder outlet obstruction due to benign prostatic hyperplasia was entered into a prospective trial of laser prostatectomy performed with the right-angle firing neodymium:YAG laser fiber at 60 watts power setting. Mean estimated resectable prostatic weight was 30 gm. with a mean prostatic urethral length of 3.3 cm. Nine patients (18%) were in urinary retention requiring catheterization before treatment. Mean energy delivery was 30,834 joules (range 14,400 to 127,800) with a mean operative time of 31 minutes. Efficacy of treatment was assessed at 3, 6 and 12 months postoperatively by standardized American Urological Association symptom scores, peak urinary flow rates and post-void residual urine volumes. At preoperative baseline the mean symptom score was 20.8, mean peak urinary flow rate 7.6 cc per second, and mean post-void residual urine volume 353 cc. At 1 year postoperatively mean symptom score was 8.4, mean peak urinary flow rate was 18.7 cc per second and mean post-void residual urine volume was 175 cc. Two patients required retreatment for residual tissue. There were 6 complications including 5 bladder neck contractures requiring incision (10%) and 1 case of postoperative prostatitis requiring antibiotic therapy (2%). Of 37 evaluable sexually active patients 31 (84%) reported preservation of antegrade ejaculation postoperatively.
Kabalin
J N
JN
Section of Urology, Palo Alto Veterans Affairs Medical Center, Stanford, California, USA.
Gill
H S
HS
Bite
G
G
D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D011468:Prostatectomy / Q000295:instrumentation / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000150:complications / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D001748:Urinary Bladder Neck Obstruction / Q000209:etiology / Q000601:surgery; D014546:Urinary Catheterization; D016055:Urinary Retention / Q000209:etiology / Q000628:therapy; D014563:Urodynamics / Q000502:physiology