2109 MID-TERM OUTCOMES OF INITIAL 250 CASE EXPEIRENCE WITH GREENLIGHT 120W-HPS LASER PHOTOSELECTIVE VAPORIZATION PROSTATECTOMY FOR OBSTRUCTIVE BENIGN PROSTATIC HYPERPLASIA: COMPARISON OF PROSTATE VOLUMES 100CC

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy and New Technology1 Apr 20112109 MID-TERM OUTCOMES OF INITIAL 250 CASE EXPEIRENCE WITH GREENLIGHT 120W-HPS LASER PHOTOSELECTIVE VAPORIZATION PROSTATECTOMY FOR OBSTRUCTIVE BENIGN PROSTATIC HYPERPLASIA: COMPARISON OF PROSTATE VOLUMES <60CC, 60-100CC AND >100CC Kevin Zorn, Gagan Gautam, Tom Deklaj, Dan Liberman, Naeem Bhojani, and Mark Katz Kevin ZornKevin Zorn Montreal, Canada More articles by this author , Gagan GautamGagan Gautam Chicago, IL More articles by this author , Tom DeklajTom Deklaj Chicago, IL More articles by this author , Dan LibermanDan Liberman Montreal, Canada More articles by this author , Naeem BhojaniNaeem Bhojani Montreal, Canada More articles by this author , and Mark KatzMark Katz Boston, MA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2305AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We conducted this study to perform a comparative analysis of the efficacy of GreenLight 120W-HPS laser vaporization in men with obstructive benign prostatic hyperplasia with prostates volumes <60, 60–100 and >100cc. METHODS The clinical data of men with symptomatic BPH who underwent PVP by a single surgeon (KCZ) between July 2007–Aug 2009 were retrospectively analyzed. Functional followup included International Prostate Symptom Score (IPSS), Quality of Life(QoL), Sexual Health Inventory for Men(SHIM) score, serum prostate specific antigen(PSA), maximum flow rate(Qmax) and post void residual(PVR) determinations and volumetric prostate measurements with transrectal ultrasonography(TRUS). Functional evaluations were performed at 3,6 and 12 months with a PSA obtained at 6 months. All men were classified into 3 groups according to TRUS volume. Change in baseline outcomes, complications and retreatment rates were compared among groups. RESULTS Among the 250 consecutive PVP patients, overall median age was 67 (range 48–91) years. Overall mean prostate volume and preoperative PSA were 57.1cc (32–170) and 3.4ng/mL (1.8–13.7), respectively. 134, 76 and 40 men had prostate volumes <60, 60–100 and >100cc, respectively. Mean laser time, energy and fibre usage were 31, 44 and 59 minutes; 163, 309 and 473kJ, and 1.4, 2.2 and 3.2 fibers, respectively (p<0.01 for all). At 1 year, mean IPSS improved 69%, 63% and 50%, Qmax increased by 194%, 175% and 162% and PVR decreased by 88%, 81% and 71%, respectively (p<0.01 for all). Mean decrease in pre-operative PSA at 6 months was 63%, 52% and 41% (p<0.01), respectively. Hospital stay, catheterization time and complication rates were comparable between groups, however retreatment rates were significantly higher for prostates >100cc (1.5% vs 2.6% vs 9%; p=0.02). CONCLUSIONS At 1 year, significant and durable improvements in the subjective and objective voiding parameters were observed in all prostate volume groups. Although larger prostates require more time and energy delivery, photo-vaporization of the prostate is safe and efficacious as an outpatient procedure for me with LUTS regardless of prostate size. However, laser vaporization for glands >100cc appears to have a reduced reduction in PSA and a higher rate of retreatment. Such findings are valuable in counseling patients undergoing PVP. Further research is required to address the optimal surgical management for men with prostate volumes >100cc. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e843 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kevin Zorn Montreal, Canada More articles by this author Gagan Gautam Chicago, IL More articles by this author Tom Deklaj Chicago, IL More articles by this author Dan Liberman Montreal, Canada More articles by this author Naeem Bhojani Montreal, Canada More articles by this author Mark Katz Boston, MA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...