1906 TO EVALUATE THE EVOLUTION OF DETRUSOR OVERACTIVITY (DO) AND BLADDER OUTLET OBSTRUCTION (BOO) IN A GROUP OF PATIENTS WITH LOWER URINARY TRACT SYMPTOMS (LUTS) DUE TO BENIGN PROSTATIC HYPERPLASIA (BPH) TREATED WITH PHOTOSELECTIVE VAPORIZATION OF THE PROSTATE (PVP)

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You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy and New Technology I1 Apr 20101906 TO EVALUATE THE EVOLUTION OF DETRUSOR OVERACTIVITY (DO) AND BLADDER OUTLET OBSTRUCTION (BOO) IN A GROUP OF PATIENTS WITH LOWER URINARY TRACT SYMPTOMS (LUTS) DUE TO BENIGN PROSTATIC HYPERPLASIA (BPH) TREATED WITH PHOTOSELECTIVE VAPORIZATION OF THE PROSTATE (PVP) Andrea Tubaro, Cosimo De Nunzio, Alberto Trucchi, Roberto Miano, Stefano Squillacciotti, Manuela Mattioli, and Lucio Miano Andrea TubaroAndrea Tubaro More articles by this author , Cosimo De NunzioCosimo De Nunzio More articles by this author , Alberto TrucchiAlberto Trucchi More articles by this author , Roberto MianoRoberto Miano More articles by this author , Stefano SquillacciottiStefano Squillacciotti More articles by this author , Manuela MattioliManuela Mattioli More articles by this author , and Lucio MianoLucio Miano More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1873AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To evaluate the evolution of detrusor overactivity (DO) and bladder outlet obstruction (BOO) in a group of patients with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) treated with photoselective vaporization of the prostate (PVP) METHODS Patients with LUTS due to BPH and BOO were enrolled.Patients underwent PVP with 80 W KTP laser. Baseline parameters included prostate volume,IPSS score with voiding and storage symptom subscores,uroflowmetry, pressure flow study and serum PSA.Follow-up visits were over a period of 1,3,6,12 months after surgery. Urodynamic evaluation was performed at baseline and 12 months postoperatively. Treatment was performed using a 80W KTP laser and a 23 Ch, continuous flow endoscope. All treatments were performed aiming a complete debulking of the adenomatous tissues as in TURP. More than one laser fibre was used when needed RESULTS Thirty patients completed the 12 months urodynamic evaluation. Mean patient age was 67±7 years; mean prostate volume was 55±16 ml. Mean IPSS was 22 ± 5,mean Qmax was 9±4.5 and median Schäfer obstruction class was 3 (3-6). An average of 189± 61 KJ was delivered over 68±24 minutes with an average of 3.4 KJ/ml of prostate. Mean number of fibers was 1.2±0.4. Median catheterization time was 18 hours. Retrograde ejaculation was reported in 67% of patients. PSA was significantly reduced at 12 months (2.6±1.8 vs 0.9±0.7, p= 0.001).Detrusor overactivity was observed in 14 pts (46%).A complete relief of DO was observed in 8 pts (26%). One patient presented a de novo DO and 6 patients still presented DO after treatment. A significant improvement of clinical and urodynamic parameters was observed 12 months after treatment. The non parametric Wilcoxon matched paired test was used for statistical analysis (Table I). Data are presented as mean (DS) or *median value Baseline Follow-up (12 months) p IPSS 23(5.7) 4.27(3) 0.000 Qmax(ml/sec) 9.5(4.6) 13.5(6) 0.000 PVR(ml) 90(98) 35(0) 0.001 URA(cmH2O) 41(16) 19(12) 0.00 Schäfer Obstruction class* 3 1 0.00 Wmax(W) 13.8(4) 12.7(4.5) 0.534 W80-W20 -2(2.7) -4(2.6) 0.02 Bladder Capacity(ml) 321(87) 356(68) 0.71 DO(%) 14(46%) 7(23.6%) 0.000 CONCLUSIONS Vaporisation of the prostate with KTP laser is a safe and effective technique.Application of a TURP-like technique results in most patients having retrograde ejaculation. A significant relief of BOO and DO as expected after a TURP can be obtained and is observed up to 12 months of follow-up Rome, Italy© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e741 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andrea Tubaro More articles by this author Cosimo De Nunzio More articles by this author Alberto Trucchi More articles by this author Roberto Miano More articles by this author Stefano Squillacciotti More articles by this author Manuela Mattioli More articles by this author Lucio Miano More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...