A prospective randomized controlled trial of hybrid laser treatment or transurethral resection of the prostate, with a 1-year follow-up.
OBJECTIVE
To compare the clinical outcome after hybrid laser treatment of the prostate, combining potassium titanyl phosphate (KTP) and Nd:YAG lasers, with transurethral resection of the prostate (TURP).


METHODS
A prospective randomized trial was conducted to compare laser treatment and TURP. The hybrid laser treatment technique involved performing initial 30 W KTP vaporizing bladder neck incisions and prostatotomies followed by a 'free-paint' application of 60 W Nd:YAG coagulation energy. Patients were re-assessed after 6 weeks, 6 months and 1 year, using the International Prostate Symptom Score (IPSS) and uroflowmetry. TURP was conducted using conventional methods.


RESULTS
In all, 204 patients were randomized into the study; at 6 weeks there were significant differences between the groups for the IPSS (12.4 vs 9.1, P=0.001) and maximum urinary flow rates (16.1 vs 20.8 mL/S, P<0. 001) in favour of the TURP group. At 6 months and one year this difference had disappeared. Similar numbers of patients in each group complained of bothersome postoperative urinary symptoms (23% vs 19%). Blood transfusions (5% vs none) and urethral strictures (9% vs 2%) were more common after TURP, whereas more early infective complications occurred after hybrid laser treatment (24% vs 5%). Only one patient in each group required re-operation because of poor resolution of symptoms.


CONCLUSIONS
At one year, hybrid KTP/Nd:YAG laser treatment of the prostate was equivalent to TURP in the improvements in IPSS, maximum urinary flow rate and post-void residual urine.
Carter
A
A
Department of Urology, The Research and Development Support Unit, Taunton and Somerset Hospital, Taunton, Somerset, UK.
Sells
H
H
Speakman
M
M
Ewings
P
P
MacDonagh
R
R
O'Boyle
P
P
D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D009929:Organ Size; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016055:Urinary Retention / Q000503:physiopathology / Q000601:surgery*; D014554:Urination / Q000502:physiology