MP42-16 ASSESSMENT OF ENERGY DENSITY USAGE DURING 180W LITHIUM TRIBORATE LASER PHOTO-SELECTIVE VAPORIZATION OF THE PROSTATE FOR BENIGN PROSTATIC HYPERPLASIA. IS THERE AN OPTIMAL AMOUNT OF KILO-JOULES PER GRAM OF PROSTATE?

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology III1 Apr 2016MP42-16 ASSESSMENT OF ENERGY DENSITY USAGE DURING 180W LITHIUM TRIBORATE LASER PHOTO-SELECTIVE VAPORIZATION OF THE PROSTATE FOR BENIGN PROSTATIC HYPERPLASIA. IS THERE AN OPTIMAL AMOUNT OF KILO-JOULES PER GRAM OF PROSTATE? Roger Valdivieso, Christian Meyer, Pierre-Alain Hueber, Malek Meskawi, Abdullah Alenizi, Quoc-Dien Trinh, Vincent Misrai, Matthew Rutman, Alexis Te, Bilal Chughtai, Neil Barber, Amr Emara, Ravi Munver, and Kevin Zorn Roger ValdiviesoRoger Valdivieso More articles by this author , Christian MeyerChristian Meyer More articles by this author , Pierre-Alain HueberPierre-Alain Hueber More articles by this author , Malek MeskawiMalek Meskawi More articles by this author , Abdullah AleniziAbdullah Alenizi More articles by this author , Quoc-Dien TrinhQuoc-Dien Trinh More articles by this author , Vincent MisraiVincent Misrai More articles by this author , Matthew RutmanMatthew Rutman More articles by this author , Alexis TeAlexis Te More articles by this author , Bilal ChughtaiBilal Chughtai More articles by this author , Neil BarberNeil Barber More articles by this author , Amr EmaraAmr Emara More articles by this author , Ravi MunverRavi Munver More articles by this author , and Kevin ZornKevin Zorn More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.204AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The ideal amount of energy delivery during photo-selective vaporization of the prostate (PVP) for optimal treatment of benign prostate hyperplasia (BPH) has not been established. The aim of this study is to assess the effect of energy density (kJ/cc) applied on adenoma during treatment on functional outcomes, PSA reduction and complications. METHODS After exclusions, a total of 440 patients that underwent Greenlight laser XPS 180W LBO PVP for the treatment of BPH were retrospectively reviewed. Data was collected from seven different international centers (Canada, the United States, the United Kingdom and France). Patients were stratified into four energy density groups (kJ/cc) according to intraoperative energy delivered and prostate volume as determined by pre-operative trans-rectal ultrasound (TRUS): group 1: <3 kJ/cc, group 2: 3 to 5 kJ/cc, group 3: 5 to 7 kJ/cc and group 4: =7kJ/cc. Energy density groups were chosen arbitrarily. PSA reduction and functional outcomes (IPSS, QoL, PVR, Qmax) were compared at 6, 12 and 24 months. Moreover, perioperative complications and retreatment rates were also compared between groups. RESULTS PSA reduction at 24 months post procedure was 51%, 61%, 79% and 83% for an energy density groups of <3, 3-5, 5-7 and =7 kJ/g respectively (p=0.01). This held true after accounting for baseline confounders. Energy density was not associated with increased complication rates, including hematuria, stricture formation, incontinence, refractory urinary retention, urinary tract infection and conversion to TURP. Functional outcomes at 2 years of follow-up were equivalent between groups (p>0.05 for all) and comparable re-treatment rates were observed (p=0.36). CONCLUSIONS Increased energy usage per cc of prostate is associated with a more significant PSA reduction (>50%) at 6,12 and 24 months suggesting increased vaporization of adenoma tissue. However this did not translate into differences in functional outcomes at two years of follow-up. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e576 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Roger Valdivieso More articles by this author Christian Meyer More articles by this author Pierre-Alain Hueber More articles by this author Malek Meskawi More articles by this author Abdullah Alenizi More articles by this author Quoc-Dien Trinh More articles by this author Vincent Misrai More articles by this author Matthew Rutman More articles by this author Alexis Te More articles by this author Bilal Chughtai More articles by this author Neil Barber More articles by this author Amr Emara More articles by this author Ravi Munver More articles by this author Kevin Zorn More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...