Change in storage symptoms following laser prostatectomy: comparison between photoselective vaporization of the prostate (PVP) and holmium laser enucleation of the prostate (HoLEP).
OBJECTIVE
To compare serial changes of postoperative storage symptoms between PVP and HoLEP, and to identify the predictors influencing postoperative improvement of storage symptoms.


METHODS
A total of 486 men (PVP group: 213 cases; HoLEP group: 273 cases), in whom 12-month follow-up data were available, were included in this retrospective study. Surgical outcomes were evaluated at 1-, 3-, 6-, and 12 months postoperatively using the IPSS, uroflowmetry with post-void residual urine volume (PVR) and serum PSA levels. Improvement of storage symptoms was defined as a reduction by ≥50 % of the subtotal storage symptom score postoperatively compared to baseline.


RESULTS
In both PVP and HoLEP groups, total IPSS, quality-of-life index, frequency score, nocturia score, maximum flow rate and PVR were significantly decreased compared to baseline starting from 1 month after surgery. Whereas urgency score was numerically increased compared to baseline at 1 month after PVP, it was reduced compared to baseline at 1 month after HoLEP. While the subtotal storage symptom score was significantly decreased compared to baseline starting from 3 months after PVP, it was significantly reduced starting from 1 month after HoLEP. On logistic regression analysis, a higher baseline subtotal storage symptom score was the only independent predictor of improvement in storage symptoms after PVP or HoLEP.


CONCLUSIONS
Our data suggest that improvement in storage symptoms after HoLEP begins earlier than that after PVP. Also, this study indicates that patients with more severe baseline storage symptoms have a higher likelihood of improvement after PVP or HoLEP compared to those with less severe symptoms.
Department of Urology, College of Medicine, Dongguk University, Goyang, Korea.
Min Chul
MC
Cho
Seung Beom
SB
Ha
Seung-June
SJ
Oh
Soo Woong
SW
Kim
Jae-Seung
JS
Paick
D000368:Aged; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000601:surgery*; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome