title: Sufficient Volume Ablation with Photoselective Vaporization of the Prostate Delivers 5-Year Durability and Improves Symptom Relief for Larger Prostates.
abstract: OBJECTIVE
  To assess the long-term durability of photoselective vaporization of the prostate (PVP) for symptomatic benign prostatic enlargement (BPE) or benign prostatic obstruction (BPO) and treatment efficacy for large BPE.
  
  
  METHODS
  Four hundred fifty-seven patients with symptomatic BPE underwent PVP between January 2006 and April 2009. Efficacy was evaluated with the International Prostate Symptoms Score (IPSS), Quality of Life (QOL) score, urinary peak flow (Qmax), postvoid residual volume (PVR), and prostate volume. Parameters were checked preoperatively, and at 1, 3, and 5 years postoperatively. One hundred fifty-three patients completed 5-year follow-up. To assess treatment effects, patients were divided into two groups according to the preoperative prostate volume: group A (<60 mL, n=104) and group B (>60 mL, n=49).
  
  
  RESULTS
  Mean IPSS, QOL score, Qmax, and PVR improved significantly and were maintained for 5 years with no significant differences; at year 1, prostate volume had decreased significantly from 54.0 mL to 30.6 mL (43% of volume ablation) and remained at that level until year 5. Investigations according to prostate size demonstrate that IPSS and QOL scores in group B remained at significantly lower levels, and Qmax in group B improved more than in group A. 1.1% of patients needed transurethral resection of the prostate due to BPO recurrence.
  
  
  CONCLUSIONS
  PVP is effective and provides durable results for 5 years, with sustained symptom relief and improved urinary flow rate, as well as a 43% volume reduction of prostate volume. Our data indicate PVP is more efficacious for larger prostates under sufficient volume ablation.
authors: 1 Department of Urology, Nagakubo Hospital , Tokyo, Japan .
authors: Hideo
authors: H
authors: Otsuki
authors: 1 Department of Urology, Nagakubo Hospital , Tokyo, Japan .
authors: Yoshitaka
authors: Y
authors: Kuwahara
authors: 1 Department of Urology, Nagakubo Hospital , Tokyo, Japan .|2 Department of Urology, Keio University School of Medicine , Tokyo, Japan .
authors: Takeo
authors: T
authors: Kosaka
authors: 1 Department of Urology, Nagakubo Hospital , Tokyo, Japan .
authors: Kenzo
authors: K
authors: Nakamura
authors: 1 Department of Urology, Nagakubo Hospital , Tokyo, Japan .
authors: Takuji
authors: T
authors: Tsukamoto
mesh_terms: D000368:Aged; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D059411:Lower Urinary Tract Symptoms / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011467:Prostate / Q000473:pathology*; D011470:Prostatic Hyperplasia / Q000150:complications / Q000473:pathology / Q000601:surgery*; D011788:Quality of Life; D012008:Recurrence; D020728:Transurethral Resection of Prostate / Q000379:methods*; D016896:Treatment Outcome; D014524:Urethral Obstruction / Q000150:complications / Q000601:surgery*