Evaluation of greenlight photoselective vaporization of the prostate for the treatment of high-risk patients with benign prostatic hyperplasia.
OBJECTIVE
To explore the feasibility and safety of greenlight photoselective vaporization of the prostate (PVP) on high-risk patients presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH) and to evaluate their clinical and voiding outcome.


METHODS
A total of 85 high-risk patients with obstructive BPH underwent PVP with an 80 W potassium-titanyl-phosphate laser, which was delivered through a side-deflecting fiber with a 23 Fr continuous flow cystoscope. Operative time, blood loss, indwelling catheterzation, international prostate symptom score (IPSS), quality of life score (QoL), uroflowmetry, postvoid residual urine volume and short-term complication rates were evaluated for all patients.


RESULTS
All patients got through the perioperative period safely. The chief advantages of PVP were: short operative time (25.6 +/- 7.6 min), little bleeding loss (56.8 +/- 14.3 mL) and short indwelling catheterization (1.6 +/- 0.8 d). The IPSS and QoL decreased from (29.6 +/- 5.4) and (5.4 +/- 0.6) to (9.5 +/- 2.6) and (1.3 +/- 0.6), respectively. The vast majority of patients were satisfied with voiding outcome. The mean maximal urinary flow rate increased to 17.8 mL/s and postvoid residual urine volume decreased to 55.6 mL. These results are significantly different from preoperative data (P < 0.05). No patient required blood transfusion or fluid absorption. There were few complications and very high patient satisfaction after operation.


CONCLUSIONS
PVP has a short operative time and high tolerance, and is safe, effective and minimally invasive for high-risk patients, therefore it might be considered as a good alternative treatment for high-risk patients with obstructive urinary symptoms as a result of BPH.
Fu
Wei-Jun
WJ
Department of Urology, Chinese People's Liberation Army General Hospital, Military Postgraduate Medical College, No. 28 Fuxing Road, Hai dian District, Beijing 100853, China. fuweijun@hotmail.com
Hong
Bao-Fa
BF
Wang
Xiao-Xiong
XX
Yang
Yong
Y
Cai
Wei
W
Gao
Jiang-Ping
JP
Chen
Yao-Fu
YF
Zhang
Cui-E
CE
D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects; D008297:Male; D010710:Phosphates; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000601:surgery*; D014025:Titanium; D016896:Treatment Outcome; D014555:Urination Disorders / Q000453:epidemiology
D010710:Phosphates; C064806:potassium titanylphosphate; D014025:Titanium