title: Photoselective prostatic vaporization for bladder outlet obstruction: 12-month evaluation of storage and voiding symptoms.
abstract: OBJECTIVE
  We evaluated voiding and storage symptom evolution in patients treated with prostate photoselective vaporization by a KTP laser.
  
  
  METHODS
  Enrolled in the study were 150 consecutive patients with lower urinary tract symptoms due to benign prostatic hyperplasia and a diagnosis of bladder outlet obstruction. Patients underwent prostate photoselective vaporization with the 80 W KTP laser. Baseline parameters included prostate volume, International Prostate Symptom Score with voiding and storage symptom subscores, uroflowmetry, pressure flow study and serum prostate specific antigen. Patients were followed 1, 3, 6 and 12 months after surgery.
  
  
  RESULTS
  Mean +/- SD patient age was 69.6 +/- 10 years. Mean prostate volume was 52 +/- 18 ml. Mean International Prostate Symptom Score was 22.3 +/- 4, mean maximum urine flow was 9 +/- 2.9 ml per second and mean Schäfer obstruction class was 3.6 +/- 1. An average of 190 +/- 44 kJ were delivered in a mean of 68 +/- 24 minutes with an average of 3.6 kJ/ml prostate. The mean number of fibers was 1.2 +/- 0.4. Mean catheterization time was 20 +/- 8 hours. Retrograde ejaculation was reported in 67% of patients. Prostate specific antigen was significantly decreased at 12 months (2.6 +/- 2.3 vs 0.9 +/- 0.7 ng/ml, p = 0.001). Storage symptoms decreased by 54.5%, 63.6%, 72.7% and 81.8% at 1, 3, 6 and 12 months, respectively (p <0.001). Voiding symptoms decreased 63.6%, 72.7%, 81.8% and 90.9% at 1, 3, 6 and 12 months, respectively (p <0.001).
  
  
  CONCLUSIONS
  As shown by a prostate specific antigen significant decrease, proper prostate debulking may be achieved by prostate photoselective vaporization. Significant continuous improvement in storage and voiding symptoms was observed at up to 12-month followup.
authors.affiliation: Department of Urology, Sant'Andrea Hospital, University La Sapienza, Rome, Italy. cosimodenunzio@virgilio.it
authors.forename: Cosimo
authors.initials: C
authors.lastname: De Nunzio
authors.forename: Roberto
authors.initials: R
authors.lastname: Miano
authors.forename: Alberto
authors.initials: A
authors.lastname: Trucchi
authors.forename: Lucio
authors.initials: L
authors.lastname: Miano
authors.forename: Giorgio
authors.initials: G
authors.lastname: Franco
authors.forename: Stefano
authors.initials: S
authors.lastname: Squillacciotti
authors.forename: Andrea
authors.initials: A
authors.lastname: Tubaro
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D011470:Prostatic Hyperplasia / Q000150:complications* / Q000601:surgery*; D013997:Time Factors; D020728:Transurethral Resection of Prostate; D001748:Urinary Bladder Neck Obstruction / Q000209:etiology* / Q000601:surgery*; D014554:Urination