High-power potassium-titanyl-phosphate (KTP/532) laser vaporization prostatectomy: 24 hours later

doi:10.1016/S0090-4295(97)00613-4

Urology

Volume 51, Issue 2, February 1998, Pages 254-256

https://doi.org/10.1016/S0090-4295(97)00613-4 Get rights and content

Abstract

Objectives. To study the feasibility and immediate postoperative outcome of vaporization prostatectomy by high-power potassium-titanyl-phosphate (KTP/532) laser in 10 men with bladder outlet obstruction due to benign prostatic hyperplasia (BPH) and to evaluate their clinical and voiding outcome 24 hours postoperatively.

Methods. The KTP/532 laser at 60 W was produced by a prototype Laserscope generator and delivered through a side-deflecting fiber with a 22F continuous-flow cystoscope. Sterile water was used for irrigation. The prostatic lobes were readily vaporized to within capsular fibers. The mean lasing time was 29 ± 8 minutes, during which a mean of 104.6 ± 30 kJ of energy was delivered.

Results. The prostate volumes ranged from 22 to 60 mL (mean 38.4 ± 9.7). None of the 10 patients had any significant blood loss or any fluid absorption. Foley catheters were removed in less than 24 hours postoperatively. All patients were satisfied with their voiding outcome. The mean peak urine flow rate increased from 8 ± 1.3 mL/s preoperatively to 19.4 ± 8.4 mL/s (142%, P = 0.003266) 24 hours postoperatively. Postvoid residual volumes remained essentially unchanged from their preoperative levels, as expected (P = 0.767423). One patient had urgency, but none had dysuria, hematuria, or incontinence or required recatheterization. Three patients have returned for 3-month follow-up; all 3 patients have had excellent results and are very satisfied with the outcome.

Conclusions. Our very early and limited experience indicates that high-power KTP/532 laser vaporization prostatectomy is feasible and appears to be safe and effective for quickly relieving bladder outlet obstruction due to BPH. Larger randomized clinical trials to compare this technique with standard transurethral resection of the prostate and more follow-up data are needed to determine its long-term efficacy and durability.

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Une étude rétrospective monocentrique a été conduite dans le service d’urologie des hôpitaux civils de Colmar, chez des patients avec une HBP symptomatique, traités par PVP, entre janvier 2016 et janvier 2019. Nous avons réparti les patients en deux groupes selon la densité d’énergie délivrée rapportée au volume prostatique mesuré en préopératoire : faible densité (< 4 kJ/mL) et haute densité (> 4 kJ/mL). L’évaluation a porté sur la survenue de complications postopératoires, l’évolution du taux de PSA total sérique et les résultats fonctionnels (score IPSS, score de qualité de vie liée aux symptômes urinaires, débit urinaire maximal et résidu post-mictionnel) avec un recul minimal de 6 mois.
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Les complications postopératoires et les résultats fonctionnels de la PVP avec le laser Greenlight XPS-180 W sont comparables en fonction de la densité d’énergie délivrée. La diminution plus importante du PSA total postopératoire pour une densité d’énergie élevée pourrait néanmoins évoquer une destruction tissulaire de meilleure qualité.
3.
Greenlight XPS-180W® (AMS, San José, USA) photoselective vaporisation of the prostate (PVP) is considered as an alternative to transurethral resection of the prostate. The objective of this study was to assess the effect of energy density applied on adenoma during PVP treatment for benign prostate hyperplasia (BPH) on postoperative outcomes.
A single-centre retrospective study has been conducted in the department of Urology of Colmar Hospital, in patients with symptomatic BPH, treated by PVP, between January 2016 and January 2019. Patients were stratified into two groups according to energy delivered and prostate volume as determined preoperatively: Low density (< 4 kJ/mL) and high density (> 4 kJ/mL). Perioperative complications, PSA evolution and functional outcomes (International Prostate Symptom Score, quality of life, maximum urinary flow rate, post-void residual urine volume) were compared with a minimal delay of 6 months. The retreatment rate was similar in the two groups.
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^☆: The prototype 800 series VHP KTP/YAG laser generator was loaned to us by Laserscope, San Jose, California. Nothing in this publication implies that Mayo Foundation endorses the products of Laserscope.

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Adult urologyHigh-power potassium-titanyl-phosphate (KTP/532) laser vaporization prostatectomy: 24 hours later☆

Abstract

Urology

Urology

Adult urology
High-power potassium-titanyl-phosphate (KTP/532) laser vaporization prostatectomy: 24 hours later☆