Eighteen-Month Results of a Randomized Prospective Study Comparing Transurethral Photoselective Vaporization with Transvesical Open Enucleation for Prostatic Adenomas Greater Than 80 cc

Skolarikos, Andreas; Papachristou, C.; Athanasiadis, Grigoris; Chalikopoulos, Dimitrios; Deliveliotis, Charalambos; Alivizatos, Gerasimos

doi:10.1089/end.2008.9709

Cited by 93 publications

(61 citation statements)

References 19 publications

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“…In our study, only 4 (13.3%) patients had a prostate volume greater than 80 mL, but we did not see any difference in efficacy or reoperation rate. Similar results were reported by Skolarikos et al, [15] who compared PVP to open prostatectomy for large prostatic adenomas (>80 mL), indicating that PVP is an acceptable treatment alternative to open surgery.…”

Section: Discussionsupporting

confidence: 86%

KTP laser photoselective vaporization of the prostate: an initial experience

Kumar¹,

Kapoor²,

Dharaskar³

et al. 2011

Turkish Journal of Urology

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Objective: To review the initial experience of potassium-titanyl-phosphate (KTP) laser photoselective vaporization of the prostate (PVP). Materials and methods:Thirty patients with benign prostatic enlargement who underwent PVP at our institution between March 2007 and June 2009 were prospectively analyzed. The efficacy of the procedure was assessed using the International Prostate Symptom Score (IPSS), Quality of Life (QoL) score, maximum flow rate (QMax), and post-void residual volume (PVR) at 3, 6, and 12 months after surgery and then annually thereafter. Operative time, laser energy and fiber use, and any procedural or postoperative complications were noted.Results: Fourteen (47%) patients opted for PVP by choice, and 16 (53%) underwent PVP because they were at high-risk for transurethral resection of the prostate (TURP), KTP laser PVP was successfully performed in all patients without any intraoperative complications. The median prostate volume was 47 g (range 25-136 g). Median operative time, laser energy, and hospital stay were 84 min (range 66-109 min), 126.1 kJ (range 27.6-235.5 kJ), and 2 days (range 1-9 days), respectively. IPSS, QoL score, QMax, and PVR improved from preoperative median values of 22, 04, 09 mL/sec, and 206 mL to 03, 01, 19.7 mL/sec, and 30.5 mL, respectively, postoperatively. No patient required blood transfusion or had TURP syndrome. Urethral stricture developed in only 2 (6.6%) patients in our study. Conclusion:Although the financial cost of laser installation is difficult to justify in developing countries, our initial results demonstrate that KTP laser PVP is a treatment method that can be adopted to treat patients with benign prostatic hyperplasia safely and effectively, especially those patients with significant systemic comorbidities. Bulgular: Ondört (%47) hasta için PVP uygulaması tercih edilirken, 16 (%53) hastaya transurethral resection of the prostate (TURP) için yüksek riskli olmaları nedeniyle PVP uygulandı. KTP lazer PVP tüm hastalarda herhangi bir intraoperatif komplikasyon olmaksızın başarıyla uygulandı. Ortanca prostat hacmi 47 gr (dağılım 25-136 gr) idi. Ortanca cerrahi süresi, lazer enerjisi ve hastanede kalış sırasıyla 84 dakika (dağılım 66-109 dakika), 126.1 kJ (dağılım 27.6-235.5 kJ), ve 2 gün (dağılım 1-9 gün) idi. IPSS, QoL skoru, QMax ve PVR, preoperatif ortanca değerler olan sırasıyla 22, 04, 09 mL/dakika ve 206 mL'den postoperatif 03, 01, 19.7 mL/dakika ve 30.5 mL değerlerine düzelme gösterdi. Hiçbir hastada kan transfüzyonu ya da TURP sendromu kaydedilmedi. Uretral darlık sadece 2 (%6.6) hastada gelişti. Sonuç:Gelişmekte olan ülkelerde lazer instalasyonunun finansal maliyetinin karşılanması zor olmakla birlikte, ilk sonuçlarımız KTP lazer PVP uygulamasının benign prostat hiperplazili hastaların, özellikle belirgin sistemik komorbiditesi olanların, tedavisinde güvenli ve etkili olarak kullanılabileceğini göstermektedir.Anahtar sözcükler: Benign prostat hiperplazisi; KTP lazer; prostat.

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Section: Discussionsupporting

confidence: 86%

KTP laser photoselective vaporization of the prostate: an initial experience

Kumar¹,

Kapoor²,

Dharaskar³

et al. 2011

Turkish Journal of Urology

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“…The relatively shorter catheterization time and lower delivered energy in our series may be related to this condition. Efficacy of PVP on BPH was shown in many studies [18,19,20,21]. In a recently published first study investigating 80 W PVP in CaP patients with BOO, Jin et al reported perfect safety and satisfying functional outcomes [8].…”

Section: Discussionmentioning

confidence: 99%

A Comparison of 120 W Laser Photoselective Vaporization versus Transurethral Resection of the Prostate for Bladder Outlet Obstruction by Prostate Cancer

Altay¹,

Erkurt²,

Kiremit³

et al. 2015

Urol Int

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Objective: To compare the mid-term outcomes of photoselective vaporization of prostate (PVP) with GreenLight HPS 120 W laser and transurethral resection of the prostate (TURP) for obstructive lower urinary tract symptoms (LUTS) in men with prostate cancer (CaP). Patients and Methods: Seventy four patients with locally advanced (T3/T4) CaP with severe LUTS or acute urinary retention (AUR) were allocated to TURP (n = 36) or PVP (n = 38). International Prostate Symptom Scores (IPSS), maximum flow rates (Qmax) and post-void residual volumes (Vres), PSA levels, prostate volumes, complications, catheter removal and hospitalization periods were recorded. Patients were reassessed at 3, 6, and 12 months. Results: The catheter removal time was significantly longer in the TURP group (3.8 ± 1.1 vs. 1.2 ± 0.7 days, p = 0.02), whereas failure of initial voiding trial was higher in PVP (2.7 vs. 13.1%, p = 0.01). No significant difference in IPSS, Qmax and Vres values was observed within the follow-up period between two groups. A significant difference in urethral stricture rate (8.3 vs. 0%), catheter removal time (3.8 ± 11 vs. 1.2 ± 0.7 days) and hospital stay (2.9 ± 0.6 vs. 1.1 ± 0.5 days) was observed in favor of PVP. Conclusions: Palliative PVP is very safe and effective by means of symptomatic relief in patients with locally advanced CaP.

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“…Başarı ve Komplikasyonlar: Açık prostatektomi sonrası AUSS' deki düzelme %63-86, IPSS'deki düzelme %60-87, postvoiding rezidü idrar miktarındaki azalma %86-98 olarak bildirilmiştir. Re-operasyon oranları yok denecek kadar azdır [11][12][13][14][15]. Açık prostatektomiye bağlı aşırı kanama eskiden büyük bir problem iken, modern cerrahi tekniklerle günümüzde kan kaybı çok azdır.…”

Section: Endikasyon Ve Kontrendikasyolarunclassified

Açık Prostatektomi Teknikleri

2015

Indications and Resection Methods of Prostate

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GirişAlt üriner sistem semptomları (AÜSS) erişkin erkeklerde en sık görülen semptomlardandır ve prevelansı yaşlanma ile artar [1,2]. Tahmini prevelans yaygın olarak kullanılan tanımlamalara ve örneklere bağlı olarak değişir, ama yaşlı erkeklerde en az bir AÜSS görüldüğü rapor edilmiştir. AÜSS depolama, işeme ve işeme sonrası semptomlarına ayrılır ve geleneksel olarak sıklıkla benign prostat obstrüksiyonu sonucu gelişen mesane çıkım obstrüksiyonu ile ilişkilidir [3,4]. Bu durum da histolojik olarak benign prostat hiperplazisinin (BPH) sonucunda gelişen benign prostatik büyüme ile ilişkilidir. BPH tedavisi denilince 20. yüzyıl başlarında açık prostatektomi ve transü-retral prostat rezeksiyonu (TUR-P) akla gelmekteydi, ancak son yıllarda medikal ve minimal invaziv tedavilerin popüler olması ile cerrahi işlem sıklığında azalma meydana gelmiştir. Ancak medikal tedavinin uzun dönem sonuçlarındaki başarısızlık ve ablasyon yapmayan tedavilerin yetersizliği nedeni ile cerrahi yöntemler son zamanlarda tekrar gündeme gelmeye başlamıştır. Genel olarak BPH için cerrahi girişim endikasyonları; 1-Kronik üriner retansiyon 2-Tekrarlayan üriner sistem enfeksiyonu 3-Medikal tedaviye yanıt vermeyen prostat kaynaklı kanama 4-BPO ya bağlı renal yetmezlik 5-Mesane taşları olarak sayılabilir.Açık prostatektomi en eski prostatektomi yöntemidir. İlk defa 1885 yılında Von Dittel tarafından bir doktora açık prostatektomi yapılmıştır. Hasta 6 gün sonra enfeksiyon ve ekstravazasyon sonucunda ölmüştür. Açık prostatektomi retropubik veya

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Eighteen-Month Results of a Randomized Prospective Study Comparing Transurethral Photoselective Vaporization with Transvesical Open Enucleation for Prostatic Adenomas Greater Than 80 cc

Abstract: Our results indicate that for an 18 month period photoselective vaporization of the prostate is a highly acceptable treatment alternative to open prostatectomy.

Cited by 93 publications

References 19 publications

KTP laser photoselective vaporization of the prostate: an initial experience

KTP laser photoselective vaporization of the prostate: an initial experience

A Comparison of 120 W Laser Photoselective Vaporization versus Transurethral Resection of the Prostate for Bladder Outlet Obstruction by Prostate Cancer

Açık Prostatektomi Teknikleri

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