Photoselective Vaporization (PVP) versus Transurethral Resection of the Prostate (TURP): A Prospective Bi-Centre Study of Perioperative Morbidity and Early Functional Outcome

Bachmann, Alexander; Schürch, Leander; Ruszat, R.; Wyler, Stephen; Seifert, Hans‐Helge; Müller, Alexander; Lehmann, Kurt; Sulser, Tullio

doi:10.1016/j.eururo.2005.07.001

Cited by 227 publications

(149 citation statements)

References 17 publications

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“…The effectiveness of the 80 W KTP Greenlight laser compared with TURP was reported in a few previous studies [14,15]. In these studies the short-term outcome for the bother score and urodynamic variables seemed to be equivalent for both procedures, with a lower complication rate in favour of the KTP laser.…”

Section: Discussionmentioning

confidence: 58%

“…In conclusion, tissue ablation with TURP is better than with the KTP Greenlight laser [5,15], but the procedure is mainly used to improve function, and there seems to be an equivalent functional outcome between these procedures. We showed that the KTP Greenlight laser can improve both the bother score and the urodynamic variables in patients with LUTS secondary to BPH over a mid-term follow-up.…”

Section: Discussionmentioning

confidence: 99%

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Vaporization of prostates of ≥80 mL using a potassium‐titanyl‐phosphate laser: midterm‐results and comparison with prostates of <80 mL

et al. 2008

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OBJECTIVETo compare the safety and outcome of potassium‐titanyl‐phosphate (KTP) GreenlightTM (Laserscope, AMS, Minnetonka, MN, USA) vaporization for treating benign prostatic hyperplasia (BPH) in prostates of ≥80 vs <80 mL.PATIENTS AND METHODSIn all, 204 consecutive patients were enrolled into this prospective study; 31 were excluded from analysis for various reasons, thus 173 (median age 66.8 years; 39 with prostates of ≥80 mL) were evaluated for maximum urinary flow rate (Qmax), postvoid residual urine (PVR), the International Prostate Symptom Score (IPSS), and quality‐of‐life (QoL) score. The median follow‐up was 11.7 months. Of the 173 men, 26.6% were anaesthesiological high‐risk patients and 32.4% took anticoagulants.RESULTSThe Qmax improved in prostates of ≥80 mL from 6.9 mL/s before to 15.3 mL/s immediately after catheter removal, and 23.4 mL/s after 3 months (P < 0.001). The improvement was similar to that in smaller prostates. There were equally effective changes in PVR (P < 0.001). The IPSS decreased from 19.0 before to 7.0, 4.0 and 5.5 at 3, 6 and 12 months after surgery (P < 0.001). Changes did not differ from those in smaller glands. The results were similar for QoL (P < 0.001). During surgery there was no major bleeding and no transurethral resection syndrome. There was acute urinary retention after catheter removal in 10.4% of men; 4.6% developed urinary tract infections, whereas the rate was higher in men with larger prostates (10.3%). The re‐operation rate was higher in men with larger prostates, at 23.1% vs 10.4% (P = 0.09).CONCLUSIONKTP laser vaporization is a safe and effective procedure for surgically treating BPH. The functional outcome in larger prostates is similar to that in smaller glands, but there was a serious trend to a higher re‐operation rate in men with larger prostates.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Vaporization of prostates of ≥80 mL using a potassium‐titanyl‐phosphate laser: midterm‐results and comparison with prostates of <80 mL

et al. 2008

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“…Following study assessment, we identified 11 trials [10][11][12][19][20][21][22][23][24][25][26] including six RCTs and five prospective casecontrolled studies (CCSs) that met our including criteria ( Table 1). Two trials of 128 patients were not available because we were unable to obtain the data for inclusion in this meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

Photoselective green-light laser vaporisation vs. TURP for BPH: meta-analysis

Ding¹,

Du²,

Lu³

et al. 2012

Asian J Androl

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This study sought to evaluate the efficacy and safety of photoselective vaporisation (PVP) vs. transurethral resection of the prostate (TURP) for patients with benign prostatic hyperplasia (BPH). Eligible studies were identified from electronic databases (Cochrane Library, PubMed and EMBASE). The database search, quality assessment and data extraction were performed independently by two reviewers. Efficacy (primary outcomes: maximum urinary flow rate (Q max ), international prostate symptom score (IPSS), postvoid residual urine (PVR) and quality of life (QoL); secondary outcomes: operative time, hospital time and catheter removal time) and safety (complications, such as transfusion and capsular perforation) were explored by using Review Manager 5.0. Six randomized controlled trials (RCTs) and five case-controlled studies of 1398 patients met the inclusion criteria. A meta-analysis of the extractable data showed that there were no differences in IPSS, Q max , QoL or PVR between PVP and TURP (mean difference (MD): prostate sizes ,70 ml, Q max at 24 months, MD50.01, P50.97; IPSS at 12 months, MD50.18, P50.64; QoL at 12 months, MD520.00, P50.96; PVR at 12 months, MD50.52, P50.43; prostate sizes .70 ml, Q max at 6 months, MD523.46, P50.33; IPSS at 6 months, MD53.11, P50.36; PVR at 6 months, MD525.50, P50.39). PVP was associated with a shorter hospital time and catheter removal time than TURP, whereas PVP resulted in a longer operative time than TURP. For prostate sizes ,70 ml, there were fewer transfusions, capsular perforations, incidences of TUR syndrome and clot retentions following PVP compared with TURP. These results indicate that PVP is as effective and safe as TURP for BPH at the mid-term patient follow-up, in particular for prostate sizes ,70 ml. Due to the different energy settings available for green-light laser sources and the higher efficiency and performance of higher-quality lasers, large-sample, long-term RCTs are required to verify whether different energy settings affect outcomes. INTRODUCTIONBenign prostatic hyperplasia (BPH) is a major cause of lower urinary tract symptoms (LUTSs) in men, especially in individuals over the age of 50 years. 1 LUTS secondary to BPH is typically characterized as voiding symptoms, such as weak stream, hesitancy, intermittency and incomplete emptying, storage symptoms, such as urgency, frequency and nocturia, and postmicturition symptoms. 2,3 Currently, the main treatment options for BPH include pharmacological therapy, such as a-adrenergic blockers and 5a-reductase inhibitors, or surgery, such as transurethral resection of the prostate (TURP), transurethral incision of the prostate and open simple prostatectomy. 4 Although TURP is the current 'gold standard' treatment for moderate-to-severe LUTS secondary to BPH, 5,6 the procedure has some limitations. Several studies 7,8 have demonstrated that the rate of complications following TURP, including transfusions, infections, urethral strictures, sexual dysfunction, urinary incontinence, urinary retention

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“…These results are comparable to 6-month outcome data published on other lasers. Bachmann et al 8 reported changes in the mean IPSS, Qmax and PVR at 6 months of À71.3, þ 162.3 and À91.2%, respectively, after photoselective vaporization with the 80 W KTP laser. Malek 4 also reported good outcome with this laser, but at the lower power of 60 W; changes in mean American Urological Association Symptom Index (AUA-SI), Qmax and PVR at 6 months were À79.1, þ 238, À81%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Preliminary results on selective light vaporization with the side-firing 980 nm diode laser in benign prostatic hyperplasia: an ejaculation sparing technique

Leonardi¹

2009

Prostate Cancer Prostatic Dis

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This study examined efficacy and safety of the 980 nm side-firing diode laser operating at a power of 100 W in patients with lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH). Patients were selected for surgery on the basis of maximum urinary flow rate (Qmax) p15 ml/s or transvesically measured post-voiding residual volume (PVR) 4100 ml in conjunction with an International Prostate Symptom Score (IPSS) 47. Laser therapy was conducted under spinal anaesthesia. Qmax, IPSS, prostate volume, PVR, IPSS-Quality of Life (QoL) questionnaire and ejaculatory function were measured at baseline and at 1, 3, 6 and 12 months post-laser therapy. A total of 52 consecutive patients aged 52-65 years with mean (s.d.) prostate volume of 45.14 (9.15) g were treated. All patients were able to leave the hospital at a mean (s.d.) of 5 (2) h after the procedure. Mean (s.d.) follow-up was 100 (75.49) days. A significant reduction in IPPS was reported at 1 month (Po0.0001) and this was maintained through to 6 months. Significant durable improvements in Qmax, PVR and IPSS-QoL score were also reported for all patients (Po0.0001). No severe complications were reported, including any cases of urinary incontinence or significant irritative symptoms. None of the patients complained of a worsening of erectile function. This early experience in a pilot study with the 980 nm diode laser seems promising in the short-term and long-term outcome is being monitored.

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Photoselective Vaporization (PVP) versus Transurethral Resection of the Prostate (TURP): A Prospective Bi-Centre Study of Perioperative Morbidity and Early Functional Outcome

Cited by 227 publications

References 17 publications

Vaporization of prostates of ≥80 mL using a potassium‐titanyl‐phosphate laser: midterm‐results and comparison with prostates of <80 mL

Vaporization of prostates of ≥80 mL using a potassium‐titanyl‐phosphate laser: midterm‐results and comparison with prostates of <80 mL

Photoselective green-light laser vaporisation vs. TURP for BPH: meta-analysis

Preliminary results on selective light vaporization with the side-firing 980 nm diode laser in benign prostatic hyperplasia: an ejaculation sparing technique

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