Outcomes of 80 W KTP Laser Vaporization of the Large Prostate

Abstract

Purpose: We evaluated the safety and efficacy of 80 W potassium-titanyl-phosphate (KTP) laser vaporization of the prostate in men with prostate volumes >70 ml. Materials and Methods: Laser vaporization of the prostate with an 80 W KTP laser was applied between September 2003 and April 2005. Preoperative evaluation of 100 patients included the International Prostate Symptom Score (IPSS), maximum urinary flow rate (Q_max), postvoid residual urine volume (PVR), prostate volume, serum sodium, creatinine, hemoglobin, prostate-specific antigen and urinalysis. Results: The mean age of the patients, mean volume of the prostates, mean operative time and mean energy delivery were 67.0 ± 7.9 (53–90) years, 98.2 ± 18.9 (74–170) ml, 150.1 ± 22.7 (100–240) min and 246.1 ± 77.8 (100–500) kJ, respectively. The serum sodium, creatinine and hemoglobin levels did not change significantly. Urinary retention requiring recatheterization was detected in 10 patients. There was moderate dysuria in 22 patients with a mean duration of 2 months and mild hematuria in 16 patients with a mean duration of 1 month postoperatively. Urinary tract infection occurred in 5 patients. We observed clot retention in 2 patients. The IPSS, Q_max and PVR values had significantly improved by postoperative months 1, 3, 6 and 12. Reoperation was performed in 5 patients. Internal urethrotomy was performed in 1 patient with bladder neck contracture. Conclusions: 80 W KTP laser vaporization is a virtually bloodless, safe and effective procedure for surgical treatment of large volume prostates.