Yonsei Med J.  2010 Nov;51(6):877-882. 10.3349/ymj.2010.51.6.877.

Impact of Prostate Volume on the Efficacy of High-Power Potassium-Titanyl-Phosphate Photoselective Vaporization of the Prostate: A Retrospective, Short-Term Follow-Up Study on Evaluating Feasibility and Safety

• Ku JH
• Kim SW
• Paick JS

• KMID: 1779634
• DOI: http://doi.org/10.3349/ymj.2010.51.6.877

Abstract

PURPOSE
We determined the impact of prostate volume on the efficacy of the high-power (80 W) potassium-titanyl-phosphate (KTP) photoselective laser vaporization of the prostate in men with lower urinary tract symptoms (LUTS).
MATERIALS AND METHODS
Patients were stratified into 3 groups according to prostate volume: '< 40 g' (n = 49) and '40-59 g' (n = 49) and '> or = 60 g' (n = 22). Median follow-up was 9 months (range 6 to 21).
RESULTS
No differences in age and follow-up duration were observed in the three groups. At baseline, no significant differences were noted in the three groups in terms of the International Prostate Symptom Score (IPSS) (21.4, 19.4 and 19.1; p = 0.412) as well as the maximum flow rate (Qmax) (10.2, 9.2, and 8.6 mL/s; p = 0.291) and post-void residual (PVR) (66.2, 80.4, and 71.5 mL; p = 0.856). The mean operative times were 30.9, 46.9, and 58.6 minutes (p < 0.001) and total median energy deliveries for each group were 62.3, 97.6, and 135.9 kJ, respectively (p < 0.001). No severe intraoperative complication was observed. At the last follow-up, these parameters improved significantly regardless of prostate volume, and the IPSS (11.1, 9.4, and 12.3; p = 0.286) as well as Qmax (15.9, 15.9, and 14.2 mL/s; p = 0.690) and PVR (33.7, 28.4, and 14.2 mL; p = 0.395) were not significantly different among the groups.
CONCLUSION
Although a larger prostate requires more time and energy delivery, photoselective laser vaporization of the prostate is safe and efficacious for patients with LUTS regardless of prostate volume.

Keyword

Prostate; benign prostatic hyperplasia; vaporization; KTP; laser surgery

MeSH Terms

Aged
Aged, 80 and over
Feasibility Studies
Humans
Laser Therapy
Male
Middle Aged
Phosphates/*chemistry
Prostate/*physiology/surgery
Prostate-Specific Antigen/blood
Prostatic Hyperplasia/complications/*surgery
Retrospective Studies
Titanium/*chemistry
Treatment Outcome
Urinary Tract/pathology
Volatilization

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