Photoselective Vaporisation of the Prostate in Men Unfit For Transurethral Resection of the Prostate - Case Report

Abstract

Transurethral resection of the prostate (TURP) is the gold standard treatment for bladder outlet obstruction. However, newer modalities, such as photoselective vaporisation of the prostate (PVP) have some significant advantages over TURP. Men who are candidates for transurethral resection of the prostate are suitable candidates PVP. The converse is not necessarily true. Patients who have an absolute requirement for anticoagulation can still be treated with PVP. We present a case study of two men at our centre with refractory urinary retention were considered unfit for TURP; both sought treatment with PVP. These men had an American Society of Anaesthesiology (ASA) Score of 4 and were also fully anti-coagulated with coumadin. Treatment was performed with the 120W lithium triborate laser. Both men successfully re-established urethral voiding and have maintained a good clinical outcome at over 2 years. This case report demonstrates that PVP may be performed safely and efficaciously in men despite medical co-morbidities, and whilst anti-coagulated.