Safety and Effectiveness of Photoselective Vaporization of the Prostate (PVP) in Patients on Ongoing Oral Anticoagulation

Ruszat, R.; Wyler, Stephen; Förster, T.; Reich, Oliver; Stief, Christian G.; Gasser, Thomas C.; Sulser, Tullio; Bachmann, Alexander

doi:10.1016/j.eururo.2006.08.006

Cited by 220 publications

(148 citation statements)

References 24 publications

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“…This experience was also demonstrated by Ruszat et al, 13 who reported a comparative study of 116 men on anticoagulants, 31% (n ¼ 36) receiving coumarin derivatives, 61% (n ¼ 71) aspirin and 8% (n ¼ 9) clopidogrel compared with 94 normal risk patients undergoing PVP. They also reported no transfusions in both groups and demonstrated similar efficacy, as well as operative time with a low adverse event profile.…”

Section: Experience With Anticoagulated and High Surgical Risk Patientssupporting

confidence: 49%

Current state of the art photoselective vaporization prostatectomy: laser therapy for benign prostatic hyperplasia

2007

Prostate Cancer Prostatic Dis

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Since the beginning of this millennium, laser technology for prostatectomy, specifically the 532 nm green light wavelength has steadily gained clinical utility, potentially replacing trans urethral resection of the prostate (TURP). Multiple clinical studies demonstrate that its unique features of minimal invasiveness with minimal morbidity are combined in a desirable, safe and efficacious procedure to treat benign prostatic hyperplasia (BPH). Early outcomes studies based on the 80 W KTP laser system are comparable to those of TURP, and favor the 532 nm laser technology especially in the light of decreased morbidity with the laser. This review will focus on the rationale for treatment and survey the data surrounding the current state of photoselective laser vaporization of the prostate, including multicenter studies, series comparing to TURP, treatment of large prostates and its use in high surgical risk and anticoagulated patients who are not ideal candidates for TURP or open prostatectomy. Finally, the new higher power 532 nm laser technology will be presented, highlighting the technological advances that will segueway the future for this technology.

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Section: Experience With Anticoagulated and High Surgical Risk Patientssupporting

confidence: 49%

Current state of the art photoselective vaporization prostatectomy: laser therapy for benign prostatic hyperplasia

2007

Prostate Cancer Prostatic Dis

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“…However, in experienced centres, such high-risk patients can be considered for operation; heparin or an equivalent high-molecular-weight anticoagulant should replace warfarin. 11,12 Appropriate prophylactic antibiotics should be given perioperatively. Temperature monitoring of the patient is recommended and warm air blankets are applied, if necessary.…”

Section: Preoperative Patient Preparationmentioning

confidence: 99%

Photoselective vaporization of the prostate (GreenLight PV): lessons learnt after 3500 procedures

Sancha¹,

Bachmann

Choi

et al. 2007

Prostate Cancer Prostatic Dis

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The technical recommendations of an international group of experts on photoselective vaporization of the prostate (PVP; GreenLight PV) for benign prostatic hyperplasia are described. Their experience stems from the treatment of over 3500 patients at five centres in Europe and the United States. The objectives of this physician-based initiative are to optimize the results achieved with PVP by standardizing the procedure, as well as to recommend training requirements.

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“…[7][8][9] Prostate vaporization using the 532 nm laser is even safe in patients undergoing PAI or anticoagulation. 10 Bipolar plasma vaporization (BPV) of the prostate has been introduced to further improve the hemostatic properties of bipolar TURP. Contemporary BPV using a hemispherical vaporization electrode combines the advantages of the bipolar technique (affordable equipment, saline irrigation) with the benefits of the 532 nm laser technique (tissue vaporization, reduced bleeding, excellent overview, and short learning curve).…”

Section: Introductionmentioning

confidence: 99%

Pure Bipolar Plasma Vaporization of the Prostate: The Zürich Experience

Kranzbühler

Wettstein

Fankhauser

et al. 2013

Journal of Endourology

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Introduction and Objectives: Bipolar plasma vaporization (BPV) has been introduced as an alternative to transurethral resection of the prostate (TURP). Promising short-term results, but inferior mid-term results compared to TURP have been reported following first-generation bipolar electrovaporization. Outcome data following second-generation BPV are still scarce. The aim of this investigation was to evaluate the intra-and postoperative outcomes of contemporary BPV in a center with long-standing expertise on laser vaporization of the prostate. Methods: A consecutive series of 83 patients undergoing BPV in a tertiary referral center was prospectively evaluated. The investigated outcome parameters included the maximum flow rate (Qmax), postvoid residual volume, International Prostate Symptom Score (IPSS)/quality of life (Qol), and prostate-specific antigen (PSA) tests. Follow-up investigations took place after 6 weeks, 6 months, and 12 months. The Wilcoxon signed-rank test was used to compare pre-and post-treatment parameters. Results: The median (range) preoperative prostate volume was 41 mL (17-111 mL). The preoperative IPSS, Qol, Qmax, and residual volume were 16 (2-35), 4 (0-6), 10.1 mL/s (3-29.3 mL/s), and 87 mL (0-1000 mL), respectively. One third of the patients were undergoing platelet aggregation inhibition (PAI). No intraoperative complications occurred. Postoperatively, 13 patients (15.7%) had to be recatheterized. Three patients (3.6%) had clot retention and 28 patients (34%) reported any grade of dysuria. After 6 weeks, all outcome parameters improved significantly and remained improved over the 12-month observation period [IPSS: 3 (0-2); Qol: 1 (0-4); Qmax: 17.2 mL/s (3.2-56 mL/s); residual volume 11 mL (0-190 mL)]. The PSA reduction was 60% at study conclusion. Three patients (3.6%) developed a urethral stricture and four patients (4.8%) bladder neck sclerosis. Re-resections were not necessary. Conclusions: Contemporary BPV is a safe and efficacious treatment option even for patients undergoing PAI. Early urinary retention and temporary dysuria seem to be specific side effects of the treatment. Bleeding complications are rare. Long-term follow-up is needed to confirm these promising short-term results.

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Safety and Effectiveness of Photoselective Vaporization of the Prostate (PVP) in Patients on Ongoing Oral Anticoagulation

Cited by 220 publications

References 24 publications

Current state of the art photoselective vaporization prostatectomy: laser therapy for benign prostatic hyperplasia

Current state of the art photoselective vaporization prostatectomy: laser therapy for benign prostatic hyperplasia

Photoselective vaporization of the prostate (GreenLight PV): lessons learnt after 3500 procedures

Pure Bipolar Plasma Vaporization of the Prostate: The Zürich Experience

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