Contact laser prostatectomy compared to TURP in prostatic hyperplasia smaller than 40 ml. Six-month follow-up with complex urodynamic assessment.
OBJECTIVE
To compare the efficacy and safety of contact laser vaporization (CLV) of the prostate and transurethral resection of the prostate (TURP).


METHODS
Fifty patients with symptomatic prostatic hyperplasia with prostate volumes less than 40 ml were randomized to CLV or TURP treatment. All patients had infravesical obstruction confirmed preoperatively by pressure-flow studies.


RESULTS
CLV lasted longer (51 +/- 13 min versus 34 +/- 12 min; p < 0.001), caused less bleeding (57 +/- 49 ml versus 175 +/- 133 ml; p < 0.001) and required longer bladder drainage time (4.3 +/- 6.1 versus 1.7 +/- 0.8 days; p < 0.01) than TURP. At 6-month follow-up, both treatments had improved objective urinary parameters and effectively reduced subjective symptoms. There were no significant differences between the study groups in symptoms scores (DanPSS-1), peak urinary flow rates (Qmax) and post-void residuals (PVR). Six months after treatment the detrusor pressure at peak urinary flow rate (PdetQmax) was 38.3 +/- 9.7 cm H2O in CLV patients and 31.3 +/- 9.9 cm H2O in TURP patients (NS). CLV treatment caused less retrograde ejaculation than TURP (1/16 potent CLV men versus 13/16 potent TURP men; p < 0.001).


CONCLUSIONS
Contact laser prostatectomy proved to be a safe procedure which improved subjective and objective urinary parameters during 6-month follow-up as effectively as TURP in the treatment of symptomatic infravesical obstruction caused by minimal or moderate benign prostate enlargement.
Tuhkanen
K
K
Department of Urology, University Hospital, Kuopio, Finland. Kari.Tukhanen@kuh.fi
Heino
A
A
Ala-Opas
M
M
D000368:Aged; D000890:Anti-Infective Agents / Q000008:administration & dosage; D002939:Ciprofloxacin / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011292:Premedication; D011468:Prostatectomy / Q000379:methods* / Q000706:statistics & numerical data; D011470:Prostatic Hyperplasia / Q000503:physiopathology / Q000601:surgery*; D018709:Statistics, Nonparametric; D013997:Time Factors; D014563:Urodynamics
D000890:Anti-Infective Agents; D002939:Ciprofloxacin