Comparison of the Effect of Transurethral Resection of Prostate and Prostatic Laserthermia for Benign Prostatic Hyperplasia

Choi, Jong Bo; Lee, Jung Gu; Cho, Jae Heung

Abstract

Benign prostatic hyperplasia is one of the most common afflictions in an aged man, but the surgery has been the only therapeutic option in the treatment of benign prostatic hyperplasia. Recently, other alternative therapeutic modalities such as pharmacological, hormonal, less invasive treatment(laser, stents, thermotherapy, etc.) were developed. The prostatic laserthermia is one of the new therapeutic tool being evaluated for the treatment of BPH. The aim of this study is that the prostatic laserthermia will be an alternative therapeutic modality for BPH as transurethral resection of prostate(TURP). A total of 92 patients(ages 49 to 90 years) who were diagnosed as BPH were included in the study, underwent uroflowmetry, transrectal ultrasound and AUA symptom scoring. 34 of 92 patients were treated with TURP. And 58 of the 92 patients were treated with prostatic laserthermia. After the treatments, each patients were followed by uroflowmetry and AUA symptom score at post operative 1, 3 and 6 months. In TURP group, the preoperative peak flow rate was changed from 8.33+/-4.5ml/sec, to 14.65+/-4.74 ml/sec, 14.67+/-4.08 ml/sec and 14.60+/-4.63 ml/sec, at postoperative lst, 3rd and 6th month respectively. The amount of average residual urine was decreased from 158.l+/-121.6 ml, to 41.9+/-22.3 ml, 43.3+/-27.1 ml and 58.2+/-27.5 ml, at 1st, 3rd and 6 month respectively. Also the AUA symptom score was decreased from 22.5+/-7.0, to 9+/-4.7, 9.3+/-4.3 and 9.5+/-5.2, at postoperative 1st, 3rd and 6th month. In prostatic laserthermia group, the preoperative average peak flow was 9.33+/-6.30 ml/sec, changed to 11.46+/-5.20 ml/sec, 11.67+/-5.40 ml/sec and 11.72+/-5.27 ml/sec at postoperative lst. 3rd and 6th month. The preoperative average mean flow was 4.75+/-2.87 ml/sec, increased to 5.47+/-2.69 ml/sec, 5.l8+/-2.69 ml/sec and 5.28+/-3.06 ml/ sec at 1st, 3rd and 6th month. The preoperative average residual urine was 130.9+/-154.7 ml/sec, decreased to 59.9+/-66.6 ml/sec, 50.6+/-57.0 ml/sec and 31.3+/-45.7 ml/sec at postoperative lst, 3rd and 6th month. The preoperative average AUA symptom score was 27.0+/-5.9, decreased 19.1+/-8.1, 18.4+/-8.7 and 17.5+/-9.1 at 1st, 3rd and 6th month. When comparing the parameters between two treatment groups, improvement of peak flow rate was greater in TURP than in Prostatic laserthermia group(p<0.01). Decrease of AUA symptom score and amount of residual urine also were greater in TURP than in prostatic laserthermia group. As the result TURP is more effective than prostatic laserthermia in peak flow rate at 1st month and AUA symptom score at lst, 3rd and 6th month t < 0.05). But laserthermia also appears to be as effective as TURP in the decrease of postvoid residuals. It could be suggested that prostatic laserthermia is an alternative therapeutic modality of BPH, especially old man who has some risk factors for operation. Key Word : transurethral resection, laserthermia.