5 years experience in BPH treatment by laser vaporisation of the prostate
Article published in Urologia Polska 2008/61/Supl. 1.

authors

Marek Lipiński, Leszek Jeromin, Waldemar Różański

II Klinika Urologii Katedry Urologii UM w Łodzi

summary

Introduction.

Treatment of BPH both pharmacological and surgical is still modernized. Minimal invasive procedure used in out-patients clinic is ideal. The potassium titanyl phosphate (KTP) laser, has been found to vaporize tissue with minimal coagulation of the underlying structures.

Objectives.

The aim of the study was to establish value of KTP laser in the treatment of BPH

Materials and methods.

From August 2003 to January 2008, a group of 259 men (51 to 84 years old) were treated with PVP method by Niagara KTP Laser 532 nm, 80 W. Preoperative prostate volume ranged from 31 to 136 cc. I-PSS and Qol estimated before the treatment exceeded in all patients 21 and 3 points respectively. Qmax ranged from 4.6 ml/sec to 14.1 ml/sec. PSA was lower then 4 ng/ml in 205 pts, in 42 ranged from 4 to 10 ng/ml and in 12 over 10 ng/ml. Evaluated PSA ratio (free/total) was in all over 20%. 211 strictly observed at the Clinic were analyzed.

Results.

The mean operation time was 41 minutes (11 to 84 minutes). 14 pts with urinary retention were catheterized after PVP. One patient without urinary retention required catheterization after PVP. 2 were catheterised in the first day after PVP. In 4 increase of body temperature to 38oC was observed in the first day after treatment. 24 hours after treatment haematuria which necessitated catheterisation was observed in one patient. 7 days after treatment in 4 pts massive haematuria was observed (2 were hospitalised). All pts experienced few days of mild dysuria. In 7 pts because of urinary retention TURP was performed 4 weeks (in one) and 8 weeks (in six) after PVP. In one patient 24 weeks after PVP incision of urethral stricture was performed. 4 weeks after PVP I-PSS decreased of 6 points, 12 weeks after of 10 and 52 weeks of 15 points. QoL as estimated in 204 pts and was less then 3 after 4 weeks. Qmax increased after 4 weeks to 16.8 ml/sec and after 12 weeks to 18.9 ml/sec. In 14 pts four weeks after PVP

bacteriuria demanding antibiotics was observed.

Conclusions.

In over 90% of treated by PVP patients I-PSS and QoL decreased after 4 weeks. Significant increase of Qmax was observed in pts after 4 weeks from PVP. In nearly 94% of pts no sings of bacteriuria were observed. In pts with prostate volume over 120 cc haematuria and incidents of urinary retention which caused TURP were observed.