Abstract
Although the photoselective vaporization of the prostate has been considered one of the most promising alternatives for treatment of benign prostatic hyperplasia (BPH), published clinical data with the surgical technology of straight beam lithium triborate laser (LBO) is still lacking. To evaluate the technical improvement and initial experience of the 160-W straight beam LBO laser photoselective vaporesection of the prostate (PVRP) for the surgical treatment of BPH. From September 2012 to September 2014, including a 12-month follow-up, a prospective randomized study was performed. 180 patients undergoing PVRP were included in the study. All patients were preoperatively assessed by International Prostate Symptom Score (IPSS), maximum flow rate (Qmax), post-void residual urine (PVR), prostate-specific antigen level, and prostate volume measurement. Perioperative parameters and complications were recorded. Patients were reassessed at 1, 3, 6 and 12 months postoperatively. PVRP resulted in a significant improvement of IPSS, Qmax, and PVR. Mean operative time was 48.3 ± 14.4 min. A significant improvement for PVRP was achieved regarding the catheter indwelling and hospital stay time. No severe perioperative complications were recorded. No requiring blood transfusion in all patients. Capsule perforation was observed in four patients in the group. There were four patients experienced bladder neck contracture and another four patients were diagnosed urethral stricture, all of whom were treated well by dilatation finally without reoperation. 160-W straight beam LBO laser PVRP appears to be a feasible and safe alternative for symptomatic BPH with decreased length of catheter indwelling and hospital stay time postoperatively.
Highlights
Reza Malek first reported photoselective vaporization of the prostate (PVP) of benign prostatic hyperplasia (BPH) using the potassium-titanyl-phosphate (KTP) 80-W system in 1996 (Malek et al 2005)
Increasing study over the past 10 years indicates that PVP with green laser is effective as trans-urethral resection of prostate (TURP) in BPH treatment (Chen et al 2012; Emara and Barber 2014; Teng et al 2013)
The green laser vaporization surgery can strongly challenge the status of TURP as the gold standard in surgical treatment of BPH
Summary
Reza Malek first reported photoselective vaporization of the prostate (PVP) of benign prostatic hyperplasia (BPH) using the potassium-titanyl-phosphate (KTP) 80-W system in 1996 (Malek et al 2005). Yong-Guang Gong reported the 120-W front-fire lithium triborate laser (LBO) photoselective vaporesection of the prostate (PVRP) for the surgical treatment of BPH (Gong et al 2014). These improvement greatly enhance the operation efficiency and reduce the risk of surgery. Increasing study over the past 10 years indicates that PVP with green laser is effective as trans-urethral resection of prostate (TURP) in BPH treatment (Chen et al 2012; Emara and Barber 2014; Teng et al 2013).
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