Photoselective vaporization of the prostate: subgroup analysis of men with refractory urinary retention.
OBJECTIVE
The purpose of this study was to evaluate the feasibility and efficacy of photoselective vaporization of the prostate (PVP) in patients with refractory urinary retention (RUR) secondary to benign prostate hyperplasia (BPH).


METHODS
Perioperative data, postoperative outcomes, and adverse events within 24 months in 70 patients with RUR were compared to 113 men with no urinary retention (NUR) before surgery.


RESULTS
Follow-up for the two groups was as follows (RUR vs. NUR at 1, 3, 6, 12, and 24 months): peak urinary flow rate: 16.9 vs. 19.4 ml/s, 16.3 vs. 20.9 ml/s, 17.7 vs. 19.7 ml/s, 18.2 vs. 21 ml/s, and 19.4 vs. 23.3 ml/s; International Prostate Symptom Score: 7.6 vs. 10.7, 7 vs. 7.5, 5.7 vs. 6.2, 5.5 vs. 6.5, and 4.4 vs. 6.5, respectively. Postoperative urinary retention and complication rates were comparable for the two groups. In five patients (2.7%), a reoperation with PVP or transurethral resection of the prostate was necessary. Bladder neck contracture and urethral stricture developed in 0.5% (n=1) and 4.9% (n=9), respectively.


CONCLUSIONS
PVP seems to be a safe and effective surgical tool in patients with RUR caused by prostatic enlargement. The complication rate is comparable to that of patients with NUR before PVP.
Ruszat
Robin
R
Department of Urology, University Hospital Basel, Basel, Switzerland.
Wyler
Stephen
S
Seifert
Hans-Helge
HH
Reich
Oliver
O
Forster
Thomas
T
Sulser
Tullio
T
Bachmann
Alexander
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000601:surgery*; D020728:Transurethral Resection of Prostate; D016055:Urinary Retention / Q000473:pathology*