Photoselective Vaporization of the Enlarged Prostate with KTP Laser: Long-Term Results in 240 Patients

Objective: In recent years, laser treatments have re-emerged as options for treating benign prostatic hyperplasia (BPH). This paper reviews the safety, efficacy, effectiveness and economics of photoselective vapourization of the prostate (PVP), compared with transurethral resection of the prostate (TURP). Methods:We conducted a comprehensive literature search to identify 14 studies comparing 80 W PVP and TURP. We then reviewed and pooled these studies. Results:We identified 12 adverse events or complications; rates were similar in both groups. No PVP patient required a blood transfusion; 5%-11% of TURP patients did. PVP patients had a significantly lower likelihood of clot retention. Collectively, the 14 studies led to the conclusion that PVP is a safe procedure. PVP is favourable to TURP regarding length of hospitalization and catheterization times. There were no meaningful differences in operation times, reoperation rates, peak flow rates, postresidual volumes or quality of life scores. Sexual function and prostate specific antigen value changes were similar. Four economic evaluations of PVP and TURP (from Canada, Switzerland, Australia and the United States) concluded that PVP is less costly per case than TURP. Cost differences are attributable to disposables, capital equipment and hospitalization. Based on our analysis of limited Canadian data, the cost of PVP is estimated to be about one-half that of TURP, even after accounting for start-up costs. Conclusion:The 80 W PVP laser appears to be a viable treatment for BPH.With the recent regulatory approval of the 120 W High Performance System (HPS), an additional option has become available. Therefore, it is anticipated that PVP will soon be considered part of a physician's repertoire for managing BPH.

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“…[10][11][12][13][14][15][16][17][18][19][20][21][22][23] Collectively, they represented a total of 1376 PVP procedures.…”

Section: Resultsmentioning

confidence: 99%

Photoselective vaporization of the prostate for the treatment of benign prostatic hyperplasia

Stafinski

Menon

Harris³

et al. 2013

CUAJ

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“…Une série a inclus des patients ayant un volume prostatique supérieur à 60 mL, avec des résultats satisfaisants, tant en post-opératoire que 12 mois après le traitement [97]. Trois séries ont étudié des patients sous traitement anticoagulant : elles n'ont rapporté aucun cas de transfusion liée à une hémorragie peropératoire [104][105][106]. Enfin, une série a comparé des patients présentant ou non une rétention urinaire réfractaire pré-opératoire : la technique semblait efficace pour tous les patients, avec un taux de complications observé identique dans les deux groupes [108].…”

Section: Discussionunclassified

Clinical Evaluation of Medical Devices

Becker¹,

Whyte²

2006

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“…24 Retrograde ejaculation (33%) is the most common complication in most long term reports, however transfusion is rarely necessary and reoperation rates are 0∼7% at 5 years. [25][26][27] The newer 120 W HPS lasers have yet to report long term results. Recent reports of 120 W laser, however, suggested that the high power also resulted in decreased hemostatic ability.…”

Section: Prostate Lasersmentioning

confidence: 99%

Basic Principles of Laser for Prostate Surgery

Kim

Moon

2011

Korean J Androl

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= Abstract =Recent advances in laser technology have provided a varied arsenal for endoscopic treatment of benign prostatic hyperplasia. Laser is a collimated coherent radiation of photons generated by stimulated emission of gain media, allowing transfer of selective, controlled and focused energy to the targeted tissue. The application of laser to prostate surgery developed hand-in-hand with refinements to the equipment. Earlier lasers were low powered modalities with no significant tissue selectivity, aimed at thermal coagulation and resulted in significant side effects and recurrence.Since then, prostate lasers have developed towards a more high-powered and selective modality that allowed complete ablation of the tissue with fewer complications. Fiber technology has also developed to allow efficient and safe transfer of a continuously increasing energy output. It is important for the surgeon to understand these fundamental principles of laser and prostate surgery, not only to select the proper tools, but also to properly implement the technique as well.

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Photoselective Vaporization of the Enlarged Prostate with KTP Laser: Long-Term Results in 240 Patients

Cited by 82 publications

References 19 publications

Photoselective vaporization of the prostate for the treatment of benign prostatic hyperplasia

Photoselective vaporization of the prostate for the treatment of benign prostatic hyperplasia

Clinical Evaluation of Medical Devices

Basic Principles of Laser for Prostate Surgery

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