Short term outcomes of high power (80 W) potassium-titanyl-phosphate laser vaporization of the prostate.
OBJECTIVE
We have evaluated the safety and efficacy of 80 W potassium-titanyl-phosphate (KTP) laser in the treatment of patients with lower urinary system symptoms (LUTS) due to benign prostatic hyperplasia.


METHODS
A total of 186 patients with LUTS have been evaluated using the International Prostate Symptom Score (IPSS) and quality of life (QoL) scoring questionnaire. Volume of prostate, post-micturition volume of residual urine (PVR), maximum flow rate (Qmax) and serum prostate specific antigen (PSA) values were determined. Laser vaporization of the prostate with an 80 W KTP was applied to all the patients. IPSS and QoL scores were evaluated on postoperative days 30, 90 and 180. The below values were measured on the postoperative days mentioned respectively: Qmax-15, 30 and 90; PSA-1, 15, 30 and 60; PVR-90.


RESULTS
The results of 186 patients, who underwent KTP laser treatment, have been evaluated. Mean age of the patients was 66+/-8 (47-90). Mean volume of prostates, mean operative time and mean energy delivery were 48.1+/-13.2 ml (26-70), 57+/-17 minutes (10-120) and 105+/-37 kJ (20-350), respectively. Following the procedures, Foley catheters were removed after a mean time of 7.59+/-0.9 hours (6-13). Compared with the preoperative period, IPSS, QoL, PVR and Qmax values decreased significantly during the postoperative period (p<0.01). Mean preoperative PSA value was 2.59+/-0.9 ng/ml (0.28-4). There were statistically significant increases in PSA values on postoperative day 1 (p<0.001). However, on postoperative day 15, PSA values decreased as low as preoperative values. There was moderate dysuria in 55 (30%) patients with a mean duration of 2 months and mild hematuria in 10 (18%) patients with a mean duration of 1 month postoperatively. Urinary tract infection occurred in 12 (6%) patients. None of the patients had fever or required re-catheterization. We observed contracture of the bladder neck in 2 (1%) patients and clot retention in 2 (1%) patients. Urinary incontinence due to operation was not observed.


CONCLUSIONS
KTP laser vaporization of the prostate is a treatment method which can be used in patients at high risk of anesthesia. This procedure is safe and effective in that it quickly relieves bladder outlet obstruction symptoms and has a low rate of postoperative complications. However, long-term follow-up studies are called for in order to ascertain whether the results of this procedure are durable or not.
Volkan
Tugcu
T
Bakirkoy Training and Research Hospital, Department of Urology, Istanbul, Turkey. volkantugcu@yahoo.com
Ihsan
Tasci Ali
TA
Yilmaz
Ordekci
O
Emin
Ozbek
O
Selcuk
Sahin
S
Koray
Kantay
K
Bedi
Ozbay
O
D000368:Aged; D000369:Aged, 80 and over; D006454:Hemoglobins / Q000378:metabolism; D006488:Hemostasis, Surgical; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000008:administration & dosage / Q000627:therapeutic use*; D011300:Preoperative Care; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000097:blood / Q000150:complications / Q000601:surgery*; D011788:Quality of Life; D013997:Time Factors; D014025:Titanium / Q000008:administration & dosage / Q000627:therapeutic use*; D020728:Transurethral Resection of Prostate; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000209:etiology; D014555:Urination Disorders / Q000209:etiology* / Q000601:surgery; D014882:Water-Electrolyte Balance
D006454:Hemoglobins; D010710:Phosphates; C064806:potassium titanylphosphate; D014025:Titanium; D017430:Prostate-Specific Antigen