title: Prostatectomy using different lasers for the treatment of benign prostate hyperplasia in aging males.
abstract: OBJECTIVE
  Endoscopic lasers have become a treatment option for benign prostate hyperplasia (BPH). The study reported here sought to elucidate the benefits and drawbacks of different laser systems in the treatment of patients with BPH.
  
  
  METHODS
  The study enrolled 741 patients diagnosed with lower urinary tract symptoms secondary to BPH during the period January 2005 to December 2011. The techniques used in the study were photoselective vaporization of the prostate, thulium laser prostatectomy, and diode laser prostatectomy. Patients were assigned to one of three groups according to the type of laser treatment they received. Outcomes were evaluated using the International Prostate Symptom Score (IPSS), quality of life, maximal urinary flow rate, post-voiding residual urine volume, and prostate-specific antigen (PSA) level.
  
  
  RESULTS
  The baseline characteristics of patients who received diode laser prostatectomy show a significant elevated risk and high American Society of Anesthesiology score (P=0.001). Operative time and catheter removal time differed significantly between the three groups (P=0.001). No cases were converted to transurethral resection of the prostate intraoperatively due to bleeding (P=0.142). Among the three groups, there were no significant differences in maximal flow rate, lower post-void residual urine, and postoperative PSA level during the entire follow-up period (P<0.05). Further, no significant differences in postoperative IPSS, quality of life, or bladder neck contracture (P=0.23) were observed. However, a significant difference was observed with regard to prolonged use of Foley catheters and prolonged hospital stay among patients in the diode laser group (P=0.001).
  
  
  CONCLUSIONS
  Laser prostatectomies are effective in dealing with lower urinary tract symptoms. Early subjective functional results (maximal flow rate, IPSS, and post-void residual urine) appeared the same as those obtained following laser prostatectomy. Thus, it appears that lasers are safe and effective as long as the patients are carefully selected for treatment.
authors.affiliation: Department of Urology, Chang Gung Memorial Hospital-Linko and Chang Gung University, College of Medicine, Taiwan.
authors.forename: Wei-Chang
authors.initials: WC
authors.lastname: Lee
authors.forename: Yu-Hsiang
authors.initials: YH
authors.lastname: Lin
authors.forename: Chen-Pang
authors.initials: CP
authors.lastname: Hou
authors.forename: Phei-Lang
authors.initials: PL
authors.lastname: Chang
authors.forename: Chien-Lun
authors.initials: CL
authors.lastname: Chen
authors.forename: Horng-Heng
authors.initials: HH
authors.lastname: Juang
authors.forename: Ke-Hung
authors.initials: KH
authors.lastname: Tsui
mesh_terms: D000368:Aged; D000375:Aging; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D016015:Logistic Models; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000503:physiopathology / Q000601:surgery*
keywords: diode laser; laser prostatectomy; photoselective vaporization of the prostate; prostate gland; thulium laser