title: High-intensity diode laser in combination with bipolar transurethral resection of the prostate: a new strategy for the treatment of large prostates (>80 ml).
abstract: OBJECTIVE
  The ideal treatment of large prostates with symptomatic benign prostatic hyperplasia (BPH) remains controversial. We compare the efficacy and safety of monopolar transurethral resection of the prostate (TURP) with high-intensity diode laser in combination with bipolar TURP (DL + b-TURP) in the treatment of large prostates.
  
  
  METHODS
  We retrospectively analyzed all patients with lower urinary tract symptoms (LUTS) secondary to BPH with prostates larger than 80 ml, undergoing monopolar TURP (n = 36) or DL + b-TURP (n = 37) between January 2008 and March 2010. The preoperative and follow-up functional parameters including International Prostate Symptom Score (IPSS), post-void residual urine (PVR), maximum flow rate (Q(max) ), quality of life score (QoLs), prostate size, and prostate-specific antigen (PSA) were assessed. The operative data, peri- and post-operative complications were also recorded.
  
  
  RESULTS
  The demographic data were comparable between the two groups. Preoperative prostate volume was 110.8 ± 28.9 ml in the DL + b-TURP group and 103.7 ± 31.2 ml in the TURP group. TURP group had significantly shorter operative time; however, the catheterization time and hospital stay were in favor of the DL + b-TURP group (P < 0.001). The decrease in hemoglobin was statistically significantly greater in the TURP group. Late complications were also comparable. Both groups could achieve significant improvements in functional outcomes during the follow-up of 24 months.
  
  
  CONCLUSIONS
  With regard to the operative safety and functional results, high-intensity diode laser combined with bipolar TURP is feasible for BPH treatment with large prostates.
authors.affiliation: Department of Urology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Chien-Hsu
authors.initials: CH
authors.lastname: Chen
authors.forename: Po-Hui
authors.initials: PH
authors.lastname: Chiang
authors.forename: Wei-Chia
authors.initials: WC
authors.lastname: Lee
authors.forename: Yao-Chi
authors.initials: YC
authors.lastname: Chuang
authors.forename: Chih-Hsiung
authors.initials: CH
authors.lastname: Kang
authors.forename: Chun-Chien
authors.initials: CC
authors.lastname: Hsu
authors.forename: Wei-Ching
authors.initials: WC
authors.lastname: Lee
authors.forename: Yen-Ta
authors.initials: YT
authors.lastname: Chen
authors.forename: Yuan-Tso
authors.initials: YT
authors.lastname: Cheng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D011470:Prostatic Hyperplasia / Q000601:surgery*; D012189:Retrospective Studies; D020728:Transurethral Resection of Prostate / Q000379:methods*; D016896:Treatment Outcome