Early results of photoselective vaporization of the prostate (PVP) in 80 patients with benign prostatic hyperplasia (BPH)
Article published in Urologia Polska 2008/61/Supl. 1.

authors

Adam Kwinta, Sławomir Mrozicki, Robert Walkiewicz

Szpital Zakonu Bonifratrów w Krakowie

summary

Introduction.

Between June 2006 and December 2007 St. John Grande Hospital of the Merciful Brothers` Order in Krakow admitted 106 patients with benign prostatic hyperplasia (BPH) who underwent PVP.

Objectives.

The aim of our study is to present early results of KTP laser vaporization in 80 patients with benign prostatic hyperplasia.

Materials and methods.

Patient age ranged from 52 to 85 years.TRUS-measured prostate volumes ranged from 40 to 140 cm3. We used the 80 Watt Green Light KTP laser (by Laserscope) with a water cooling system and generating monochromatic light at 532 nm.

Results.

Of the 106 patients 80 subjects followed up for at least 6 weeks after PVP were included in the final analysis. The duration of the procedure ranged from 30 to 155 min. The energy delivered by the laser ranged from 17.400 J to 316.000 J .In 23 patients with prostate volumes greater than 100 cm3 the mean procedure duration was 118 min, and the mean laser energy delivered was 224.000 J. A large proportion of patients (26%) were considered high risk for surgery and anesthesia. Twelwe patients

15%) had complete urinary retention requiring catheterization, another 8 (10%

ml/s. Postvoid residual urine volume was 0-40 ml. The IPSS decreased after surgery by 5 points on average.

Conclusions.

After PVP all patients were able to void spontaneously or urinary flow rate and quality of life improved markedly. Remarks on the technique of PVP:Great care must taken at the start of the procedure not injure the dalicate mucosa when advancing the obturator apparatus, therefore precision isequired when performing opticalurethrotomy prior PVP. For the same reason stones were crushed in the bladder after and not before PVP. In large prostates it is important to vaporize also the apex of the lobes at the level of the verumontanum, similarly TURP. In patients after acute inflammatory states – adenomitis it is reasonable to delay PVP until after completion of

appropriate antibiotic therapy to avoid poor visibility along the optical path. PVP may be a useful alternative to open surgery or TURP in high risk patients. With proper patient selection PVP may be performed in patients with prostate volumes greater than 100 cm3.