1979 PHOTOSELECTIVE VAPORIZATION OF THE PROSTATE (PVP) PRIOR TO RADIATION IS SAFE AND EFFECTIVE AT TREATING SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA (BPH) IN MEN DIAGNOSED WITH PROSTATE CANCER

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy and New Technology I1 Apr 20121979 PHOTOSELECTIVE VAPORIZATION OF THE PROSTATE (PVP) PRIOR TO RADIATION IS SAFE AND EFFECTIVE AT TREATING SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA (BPH) IN MEN DIAGNOSED WITH PROSTATE CANCER Michael Shy, Thomas Gerald, Kumaran Sathyamoorthy, Andrew Lee, and Ricardo Gonzalez Michael ShyMichael Shy Houston, TX More articles by this author , Thomas GeraldThomas Gerald Houston, TX More articles by this author , Kumaran SathyamoorthyKumaran Sathyamoorthy Houston, TX More articles by this author , Andrew LeeAndrew Lee Houston, TX More articles by this author , and Ricardo GonzalezRicardo Gonzalez Houston, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2139AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Benign prostatic hyperplasia (BPH) and prostate cancer (CaP) are common in aging men and often coexist. There is no published data on men with symptomatic BPH and CaP who opt for treatment with photoselective laser vaporization of the prostate (PVP) prior to undergoing radiation therapy (XRT). The primary purpose of this retrospective review is to examine the complications of PVP followed by XRT with a secondary goal to evaluate symptom score changes. METHODS Over a 32-month period, we reviewed 40 consecutive patients with symptomatic BPH diagnosed with prostate cancer who elected to undergo PVP prior to external beam XRT for primary CaP treatment. Preoperative assessment included prostate volume, International Prostate Symptom Score (IPSS) as well as uroflowmetry, cystometry and pressure-flow studies. Postoperative assessments of IPSS, flow, and post-void residuals (PVR) were examined at months 1, 3, 6, and 12. Complications were monitored throughout the follow-up process and identified by chart review. RESULTS Preoperative characteristics included mean age [70.8 ± 5.9], prostate volume [66.3 ml ± 23.9], and PSA [8.2ng/mL ± 6.2]. All patients were catheter-free by postoperative day 1. Primary endpoints were surgical complications. Short-term complications included delayed hematuria (5%), urinary retention (7.5%) and urinary tract infections (10%). There was no stress urinary incontinence or urinary fistulas. Two men required reoperation. The first presented 2 weeks postoperatively in clot retention requiring cystoscopic evacuation and fulguration. The second presented 22 months postoperatively with dysuria and weak stream, and was found to have a calcified prostatic fossa, which was resected without complication. Secondary endpoints were changes in voiding parameters reflected by IPSS, flow and PVR. The mean preoperative IPSS decreased from 20.8 preoperatively to 7.6, 7.6, 4.6, and 7.3 at 1, 3, 6, and 12 months respectively. Mean flow rate increased from 9.0 ml/s, to 19.0, 21.0, and 16.0 at 1, 3, and 12 months respectively. The mean PVR decreased from 91.5 ml to 11.9, 15.8, 18.3, and 9.6 at 1, 3, 6, and 12 months respectively. Postoperative voiding measures did not seem to worsen after XRT. CONCLUSIONS Whereas complications have been described with transurethral resection of the prostate (TURP) and PVP after XRT, this limited study suggests that PVP prior to XRT in the patient with concomitant symptomatic BPH and CaP is safe and can improve voiding symptoms in this group of men. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e798-e799 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Shy Houston, TX More articles by this author Thomas Gerald Houston, TX More articles by this author Kumaran Sathyamoorthy Houston, TX More articles by this author Andrew Lee Houston, TX More articles by this author Ricardo Gonzalez Houston, TX More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...