Effects of Photoselective Vaporization of the Prostate on Urodynamics in Patients With Benign Prostatic Hyperplasia

Abstract

We evaluated the effects of photoselective vaporization of the prostate on efficacy outcomes and urodynamic parameters in patients with benign prostatic hyperplasia. The efficacy and morbidity of photoselective vaporization of the prostate were prospectively analyzed in 135 patients who underwent this therapy. Treatment efficacy was assessed regarding outcome variables, including International Prostate Symptom Score, quality of life score, peak urinary flow rate and post-void residual urine volume 3, 6 and 12 months postoperatively. Urodynamic evaluations, including cystometry and a pressure flow study, were performed before and after the operation in 78 patients. Perioperative values and postoperative complications were also noted. Significant improvement was observed in all outcome variables with significant relief of bladder outlet obstruction and detrusor overactivity, and a minimal change in detrusor contractility following photoselective vaporization of the prostate. The preoperative and postoperative overall rate of detrusor overactivity was 47.4% and 26.9%, respectively. The median preoperative and postoperative degree of obstruction according to the Schafer nomogram was 4 (IQR 3, 4) and 1 (IQR 0, 1), respectively. Decreases in serum sodium and hemoglobin were negligible. Two patients required intervention for postoperative bleeding. There were 2 newly documented cases of urethral stricture. Two patients required reoperation for postoperative dysuria. Photoselective vaporization of the prostate is considered a safe and effective treatment with minimal bleeding and no hyponatremia, thus providing successful relief of bladder outlet obstruction and detrusor overactivity without affecting detrusor contractility in patients with benign prostatic hyperplasia.